Evaluation and Staging of Testicular Malignancy

Testicular cancers are relatively uncommon and are found in less than 1% of male population with median age of presentation between 15 and 35 years. Ninety percent of the testicular tumors are germ cell tumors, which can be broadly classified into seminomatous and non-seminomatous (NSGCT). A complaint of painless testicular swelling or nodule, which is usually observed by the patient himself or their partner, is the first presenting complaint. Other symptoms like testicular heaviness, pressure-like sensation, and mild to moderate pain may be present. Testicular pain is not a usual complaint and is seen in only 10% patients. Painful testicular swellings are initially treated on the lines of acute orchitis or epididymitis (suspecting infectious cause) or other causes like testicular torsion. An ultrasound may become necessary to rule out cystic and solid testicular swelling. CT scan of abdomen, pelvis, and thorax is recommended for staging of testicular germ cell tumors. This chapter details the evaluation and staging of common testicular tumors.