Testicular seminoma is classified as a malignant neoplasm, which quickly metastasizes to retroperitoneal lymph nodes, and then to internal organs, including the lung, liver, brain and bones. Testicular seminoma is well treated, so patients have a good chance of a full recovery, even with distant metastases.

Testicular seminomais a solid tumor that develops in men after 40 and 50 years of age. Specialists distinguish two types of seminomas:

  • classic nasieniak
  • spermatocyte seminoma

Another division of seminomas takes into account the severity of the disease. And so: stage one, in which the tumor is confined to the scrotum and there are no lymph node and distant metastases

  • second degree is a situation in which, in addition to the primary tumor in the testicle, there are metastases to the lymph nodes (in the retroperitoneal space of the abdominal cavity or pelvis)
  • the third degree is a condition with distant metastases, e.g. to the lungs, brain, bones

Testicular seminoma - causes

So far, not all the causes of testicular seminomas have been identified. Only a few of the factors contributing to the disease have been identified. They are:

  • cancer in the second testicle, which is the strongest factor in the formation of seminoma
  • family history of testicular cancer increases the risk of developing testicular seminoma several times
  • male infertility
  • HIV infection
  • genetic and developmental disorders
  • testicle failure in childhood

Testicular seminoma - symptoms

The most common symptom of seminoma is a new thickening in the vicinity of one of the testicles or a change in the size or shape of an organ, which is palpable during self-examination. This is the first signal to seek the advice of a urologist. The visit should not be delayed as this cancer quickly spreads to the lymph nodes and other organs. Early diagnosis allows for faster implementation of treatment, and thus for recovery.

Not all seminomas can be detected by palpating the testicles. It happens that changes are not felt in either the testicle or the scrotum.

Sometimes the first symptoms of seminoma are recognized bydetection of changes in lymph nodes, liver or lung.

Less common symptoms include:

  • lose weight
  • unreasonable fatigue
  • breast swelling or breast enlargement (related to the secretion of hormones by the tumor)
  • low back pain associated with compression of the lymph nodes on the nerves coming out of the spine
  • shortness of breath
  • chronic cough (when lung metastases occur)

It is worth knowing that in the case of all testicular neoplasms, pain from the perineum is quite rare. Seminomas are sometimes confused with orchitis, but keep in mind that this usually affects both organs.

Semienioma develops in one testicle. Post-traumatic changes in the testicles, which may cause bothersome symptoms, usually disappear a few days after the event.

Testicular seminoma - diagnosis

If a testicular seminoma is suspected, the doctor recommends an ultrasound examination. It is very reliable and makes it easier to make a correct diagnosis.

Confirmation of a solid lesion (tumor) in USG is a sufficient basis for qualifying for an orchidectomy, i.e. testicle amputation.

To assess the advancement of the disease, it is also necessary to perform computed tomography of the abdominal cavity, pelvis and chest.

The determination of tumor markers in the blood serum is also a routine activity. Markers are important in monitoring the patient after treatment (they help in the early detection of recurrence). In the blood serum, the following is marked:

  • beta subunit of chorionic gonadotropin (β-hCG)
  • α-fetoprotein - abnormal levels of this marker indicate that we are dealing with a tumor with a mixed histological structure (non-seminoma)
  • lactate dehydrogenase (LDH)

When computed tomography (CT) gives an ambiguous result as to the advancement of the disease, positron emission computed tomography (PET) can resolve diagnostic doubts.

Testicular seminoma - treatment

Treatment of testicular seminoma, like all other cancers, depends on the severity of the disease. In each case of seminoma, the testicle is initially surgically removed through the groin. This is done by urology and oncology centers.

When the disease is at the lowest stage (no metastases to the lymph nodes and distant organs, the tumor is located only in the scrotum), then the method of choice after surgery is radiation therapy of the abdominal and pelvic lymph nodes.

In some centers, chemotherapy is used instead of radiotherapy.

The purpose of such treatment ispreventing the recurrence of seminoma in the lymph nodes. In the treatment of seminomas, adjuvant treatment is very rarely withdrawn and the patient is only monitored during frequent check-ups, which should be performed every 3 months.

A higher-stage seminoma (the disease has spread out of the scrotum and has spread to the lymph nodes) requires more aggressive treatment.

When the lymph nodes are less than 5 cm in size, the doctor recommends high-dose irradiation of the lymph nodes.

In the case of enlargement of the lymph nodes more than 5 cm, the method of choice is chemotherapy. Usually these are 3-4 cycles of chemotherapy.

In the case of metastases to other organs (e.g. lungs), the doctor will immediately refer the patient to chemotherapy.

Testicular seminoma - prognosis

Despite the fact that seminoma is a malignant tumor, the chance of complete recovery from the disease is high. Due to aggressive progression, the disease quickly metastasizes. That is why it is so important to quickly diagnose the disease and its stage.

If the testicular seminoma has not spread beyond the scrotum, the chance of a complete recovery is very high, almost 100%.

When metastases to distant organs occur, the prognosis is slightly worse.

Patients who have metastases to the lung and lymph nodes have a slightly greater chance of recovery, and slightly worse when the cancer has spread to the liver or bones.

Testicular seminoma - after treatment

It is extremely important to have regular he alth checks after treatment for testicular seminoma is completed. Each patient should be checked by the doctor.

During the follow-up visits, the doctor makes sure that the disease has not recurred.

Performing appropriate tests and marking markers allows you to control the disease. This is important because recurrence is always associated not only with a more aggressive form of seminoma, but also with more radical and more difficult treatment for the patient than was the case with the original onset of testicular seminoma.

Testicular seminoma - prevention

First of all, you should protect yourself from sexually transmitted infections, mainly HIV infection.

Another preventive measure is self-examination of the testicles. Every man should do them once a month. The test should be performed during a warm bath, with the skin of the scrotum not shrinking.

One testicle is always slightly larger than the other, and it is a physiological state. You should be anxious by significantly increasing the size or shape of one of thethem.

When examining the testicle, hold the testicle between the thumb and fingers of each hand with both hands, slowly moving the fingers over the surface in search of lumps and irregularities.

Each kernel is tested separately.

If any changes are detected, it is necessary to visit a urologist who will dissolve or confirm the fears of disturbing changes in the testicle.

About the authorAnna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

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Category:

Oncology