investigations in testicular cancer
Last reviewed 12/2022
NICE recommends that all patients with a swelling or mass in the body of the testis should be referred urgently for investigation (1).
These include:
- scrotal ultrasound
- investigation of choice
- has a sensitivity of almost 100% in diagnosing testicular tumour
- used to explore the contralateral testis (2)
- urgent ultrasound should be carried out in men with
- a scrotal mass that does not transilluminate
- when the body of the testis cannot be palpated, such as when there is
a reactive hydrocele (1)
- tumour markers -
- are prognostic factors used in diagnosis and staging (2)
- includes -
- serum beta human chorionic gonadotrophin (HCG)
- lactate dehydrogenase (LDH) - measured specially in advanced disease
- alpha-fetoprotein (AFP) *
- lack of an increase does not exclude the disease
- chest radiography for metastases
- CT scan of the chest, abdomen and pelvis in order to stage the disease
- testicular exploration and biopsy
* Note that elevated serum AFP levels indicate the presence of yolk sac elements, i.e. mixed germ cell tumours (especially embryonal carcinoma and yolk sac tumours).
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