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Testicular cancer

The prognosis for testicular cancer is very good with modern treatment.

The majority of malignant tumors in the testes are germ cell tumors. Approximately 90% of all of these germ cell tumors originate in the testes (3).

Testicular germ cell tumors are separated into two main types:

  • Seminoma
  • Nonseminoma (often a mix of two or more cell types)
    • Embryonal carcinoma
    • Yolk sac tumor
    • Choriocarcinoma
    • Teratoma

The occurrence of the two types are about the same, however, they differ in aggressiveness and response to treatment. Seminomas peak later in life with a median age of 35 years while nonseminomas have a median age of 25 years.  

Mixed tumors with a seminal component are classified as nonseminomas. 

Ten to fifteen percent of all testicular germ cell tumors occur extragonadal, particularly retroperitoneally and in the mediastinum. Primary retroperitoneal germ cell tumors are most often associated with an occult testicular cancer, especially if the tumor is in the midline. Mediastinal extragonadal tumors are most often mature teratomas.

About 5% of all testicular tumors develop from other cell types in the testicle, primarily from hormone-producing cells (Leydig cells) or sex cord-gonadal stromal tumors (for example Sertoli cells).

Pediatric testicular tumors develop very differently than in post-pubescent men. Pediatric testicular tumors are therefore not discussed here in detail. (See childhood cancer)

Incidence

In 2013, there were 337 new cases of testicular cancer registered in Norway (1). Germ cell tumors are the most common solid tumors in men between 15 and 35 years. The incidence of testicular cancer is increasing and varies with geographic area and race. The incidence is highest in Denmark, Norway, Germany, and Switzerland. The lowest incidence is observed in Africa and Asia (3).

 

Age-specific incidence of testicular cancer, 2009–2013.

Source: Cancer Registry of Norway

 

 

Incidence of testicular cancer, 1954–2013.

Source: Cancer Registry of Norway

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