Diagnosis
-H&P
-Risk factors: Cryptorchidism especially if orchiopexy is done after puberty.
-DDx and etiology.
Imaging: U/S
Biopsy: contraindicated if U/S suggestive of testicular cancer since it may contaminate the scrotum or alter the lymphatic drainage.
CT (chest, abdomen, and pelvis) + measurement of the tumor markers for staging and as an indication of tumor burden.
Treatment
-Refer to urology.
-Radical inguinal orchiectomy (both diagnostic and therapeutic).
Tumor markers: Serum b-hCG, a-fetoprotein, and LDH levels
Reference / Further Reading
Am Fam Physician. 2018 Feb 15;97(4):261-268. Testicular Cancer: Diagnosis and Treatment.https://www.aafp.org/afp/2018/0215/p261.html
Hanna NH, Einhorn LH: Testicular cancer—Discoveries and updates. N Engl J Med 2014;371(21):2005-2016