1 / 8

Update on Testicular Cancer Recognition for Primary Care Physicians

This update covers a case study of a 40-year-old man presenting with testicular lump, discussing diagnosis, treatment progression, and eventual confirmation of seminoma through histological analysis and subsequent treatment modalities. Relevant guidelines and referral pathways are also highlighted.

mcmiller
Download Presentation

Update on Testicular Cancer Recognition for Primary Care Physicians

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Urology cancer update for primary care Jacob Cherian June 2019

  2. Testicular Lump - Case study Day 1 A 40-year-old man – Mr G – attends accident and emergency with a painfully swollen testis. He is seen by a specialist registrar – Dr A – who makes a diagnosis of epididymo-orchitis. Mr G is given a seven-day course of the antibiotic co-amoxiclav and advised to see his GP for follow-up.

  3. Testicular Lump - Case study Day 7 Mr G attends for an appointment at his local general practice surgery. He is seen by Dr B who notes the A&E attendance and antibiotic prescription. The patient reports improvement in his condition but there is still some slight swelling. Dr B prescribes a further seven-day course of antibiotics but this time with ofloxacin.

  4. Testicular Lump - Case study Day 16 Mr G phones requesting an urgent appointment. He is concerned that the swelling has not cleared with the second course of antibiotics. Dr B examines the patient again and identifies a small non-tender cyst in the left epididymis but the testis is “normal”. Dr B reassures the patient and instructs him to return in two weeks if the symptoms have not settled.

  5. Day 37 Mr G attends the practice again complaining of a persistent and painful swelling. He sees Dr B and expresses his worry that he might have testicular cancer. Dr B notes “Left testicular pain persists, lump adherent to upper pole” and he refers the patient for an ultrasound investigation of the testicle and issues a further prescription of the antibiotic ciprofloxacin.

  6. Day 51 • Mr G is referred to a urologist the next day. • The urologist finds several focal lesions consistent with tumour on the scan. • On examination he detects a hard tender mass at the upper pole of the left testis. • Two days later Mr G undergoes an Orchidectomy • Histological analysis confirms a diagnosis of seminoma. • A CT scan shows enlargement of the peri-aortic lymph nodes on the left side • Mr G undergoes both chemotherapy and radiotherapy.

  7. Suspected cancer: recognition and referral NICE guideline [NG12] Published date: June 2015 Last updated: July 2017 Testicular cancer Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for testicular cancer in men if they have a non‑painful enlargement or change in shape or texture of the testis. [new 2015] 1 Consider a direct access ultrasound scan for testicular cancer in men with unexplained or persistent testicular symptoms. [new 2015]

  8. Scrotal lump Painless Painful Transluminate Hydrocele • Epididymal cyst • Spermatocele • Epididymo-orchitis • Torsion • Rarely Testicular tumour Extra-testicular Bag of worms varicocele Reducible Hernia Painless / hard Tumour

More Related