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The use of estrogens by the mother during pregnancy may result in their children a higher incidence of testicular tumors, testicular atrophy (small testes) or cryptorchidism (testicles out of its usual position).

Let me say in passing that patients with cryptorchidism have a 50 times greater risk of developing testicular tumor than normal patients.

What you feel and how is it diagnosed?

Testicular tumors may present as painless nodules or by increasing the volume of the organ. Some patients notice the problem by increasing the weight of the testis. These changes can progress without the patient's perception. In other cases - about 10% of cases the tumor may have internal bleeding, causing an acute condition that can be confused with other benign testicular inflammation (eg, orchitis). In 15% of cases, there are already metastases and symptoms will emerge as the area involved as:     cough or dyspnea (lung)
    back pain (retroperitoneal)
    lower extremity edema (vena cava involvement) and other


Breast enlargement (gynecomastia) may also occur in some testicular tumors. It occurs due to increased production of estrogen deficiency or by the formation of androgens.

On physical examination, the patient usually palpate the testicle lump or firm painless.

Other structures of the scrotum (epididymis, vas deferens) are not involved, except in more advanced cases.

Any acute condition involving the testis in young people and that does not resolve in 7-10 days of conventional treatment should raise suspicion by the presence of tumor. In 10% of cases, the patient presents with signs of metastatic disease such as pain, dyspnea , vomiting, gynecomastia, loss of weight

After performing the physical examination, laboratory tests are required to confirm the diagnosis, such as:     alpha fetoprotein and beta-HCG which is tumor markers, ie, substances produced by tumors and which are increased in their presence. 8% of seminomas produce beta-HCG whereas 0% produce alpha feto-protein non-seminomas tumors produce both markers in about 60% of cases.
    testicular ultrasound, which gives us the idea of the volume and location of the tumor, and gives us the image of the other testicle.
    total abdominal tomography, which search the retroperitoneum (area located behind the abdominal cavity) in search of nodal metastases.
    Chest X-ray or CT scan of the chest.


Once confirmed the clinical suspicion, the next step is inguinal exploration. It holds an incision in the groin of the patient and the testicle it is pulled. A fragment of the lesion (biopsy) is removed and sent to the pathologist. If confirmed the presence of malignant tumor, the testicle is excised (orchiectomy).

The testis is an organ composed of different types of cells, which can generate different types of tumors, each with a peculiar behavior, with varying degrees of malignancy.

The tumors can also be composed of different cells. They are mixed tumors.

It is not the purpose of this article provide detailed knowledge of cell groups of the testis. However, these can be divided into two major groups:     tumors and seminomas  non-seminomas.


Treatment

Knowledge of the cellular component of the tumor and the presence or absence of metastasis is to guide the tratamentofuturo.

There are several forms of treatment:     Radical orchiectomy (OR)
    OR + retroperitoneal lymphadenectomy (removal of the retroperitoneal lymph)
    OR + chemotherapy
    OR + + chemotherapy lymphadenectomy
    OR + radiotherapy (radiation therapy is indicated in seminomas)


The choice of optimal treatment will depend on the extent of disease (staging) and histological type. There are also the preferences of each urologist who should also be considered.

What is the prognosis?

The prognosis varies with cell type and tumor extension.

Over the past 25 years due to tumor markers, the diagnostic and chemotherapy, there was a significant improvement in patient survival, even in the later stages of the disease.