Testicular cancer is the most common malignancy in men aged 15 to 45 years and represents one of the most common curable malignancies when identified promptly and treated with a multimodal approach. It represents 1% of male tumors and 5% of urological malignancies. The incidence of testicular cancer has been increasing over recent years, gaining increased significance due to the long impact both the disease and its treatment can have over the course of a patient's life. Testicular cancer incidence has doubled over the past 40 years.
With effective management, the prognosis is excellent with >90% cure rate and >95% five-year survival rate. Complex environmental and genetic factors are involved in the development of testicular cancer; common risk factors include cryptorchidism, family history of testicular cancer, personal history of testicular cancer in the contralateral testis, age, and ethnicity. Initial evaluation includes history and physical examination, tumor marker assessment, and scrotal ultrasound. Once a solid intratesticular tumor is identified, radical inguinal orchiectomy is performed both for diagnostic and therapeutic purposes. Tumor staging guides further management with options including active surveillance, chemotherapy, retroperitoneal lymph node dissection, and radiation therapy.
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