Tumor formations on the internal genital organs are most often found in women. But this does not mean that men do not suffer from this type of pathology. Testicular seminoma is diagnosed in 90% of cases of tumor development. The danger of this disease is that most often it is malignant.
A tumor is formed from germ cells (pluripotent). The main area of its damage is the structure of the testicle. Most often, the neoplasm develops in men in young and middle age. In exceptional cases, pathology can occur in elderly men and young children.
Seminoma is considered a common pathology, as it accounts for about 40% of all tumors arising in the testicles. Neoplasms that form on testicular tissue account for 90% of all tumor formations in men.
- The first: the formation of a neoplasm in which the testicle is not yet deformed and the tunica albuginea is intact.
- Second: the seminoma is local, the tunica albuginea is damaged, the testicle is deformed.
- Third: the spread of metastases to the lymph nodes is added to the existing pathological processes.
- Fourth: the overall clinical picture is complicated by damage to internal organs by metastases.
It is worth noting that the tumor can be benign. In this case, the classification of the development of the disease by stages is not taken into account, since the pathology does not progress according to the described scheme.
Symptoms of seminoma
Symptoms of seminoma may be absent throughout the course of the disease. Only in some cases do patients experience discomfort in the groin area. A neoplasm can be diagnosed only by assessing the condition of the organ. With pathology, the testicle enlarges and thickens.
In exceptional cases it is noted:
- potency disorder
- hormonal imbalance
- gynecomastia
- early puberty
When the tumor grows to its maximum size (30 cm), hemorrhage may occur in the testicle or.
The manifestation of symptoms of the disease is observed at the third stage of development. At this stage, the spread of metastases begins, which lead to disruption of the functioning of other organs, and as a result, the appearance of signs of the disease.
Symptoms of metastasis
Depending on the area in which metastases appear, the patient experiences certain:
- Retroperitoneal lymph nodes: pain in the lumbar region
- Para-aortic lymph nodes: abdominal pain and swelling of the legs
- Intra-abdominal lymph nodes: abdominal pain and intestinal obstruction
- Liver: enlarged liver, jaundice and ascites
- Lungs: cough, shortness of breath and hemoptysis
- Skeleton: painful sensations in the bones
The more the pathological process progresses, the more the patient’s condition worsens. The third stage is marked by: weight loss, nervousness, anemia and weakness. External signs include scrotal asymmetry.
Diagnosis of the disease
In most cases, patients come to a medical institution with complaints when there are already metastases.
Diagnosing the disease at this stage is not difficult. In order to determine the clinical picture and establish a diagnosis, a number of diagnostic studies are carried out:
- interview and examination of the patient
- collection of analyzes
- hardware examination
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A neoplasm can be detected using an ultrasound of the scrotum and adjacent organs. To detect metastases, the doctor sends the patient to undergo hardware diagnostics:
- chest x-ray
- MRI of the liver
- CT abdominal cavity
- scinography of skeletal bone tissue
Additional examination methods may be prescribed depending on the stage of the pathology and the characteristics of the body.
An obligatory step is taking tests for tumor markers. It is this study that determines whether the tumor is malignant.
Tumor treatment
A tumor developing on the testicle is treated. But the stage of pathology at which the disease was diagnosed plays a big role. First things first initial stages progression of the disease can be cured completely.
In the first two stages, a therapeutic method of influence is used. However, therapy is carried out using radiation or chemical irradiation. At the third stage, surgical intervention is possible.
The most dangerous seminoma is at the third and fourth stages, when metastases not only penetrate the lymph nodes and other organs, but also begin to grow. It is the malignant form of the disease that leads to an increased risk of death. In some cases, the patient is saved by removing the affected organ, as well as tissues with metastases. Treatment is carried out on an individual basis, since the scheme of all therapy is influenced by large number factors.
Chemotherapy is mandatory after tumor removal. The technique is also used for several months after surgery. Chemical radiation is the only treatment option that prevents the spread of metastases and the growth of cancer cells.
Treatment by stages
Testicular seminoma develops in the male body in stages. Accordingly, it is carried out depending on at what stage the disease was detected. Naturally, treatment at the first stage is carried out more successfully, and the body is not heavily affected by drug intervention.
First stage
The tumor affects only the testicle, so all doctors’ actions are aimed at eliminating the tumor before it begins to progress further. Treatment is carried out after the patient has undergone a complete diagnosis.
At the first stage of the pathology, radiation therapy is performed, which exposes the groin lymph nodes on the side of tumor formation, as well as the retroperitoneal lymph nodes. Irradiation of the supraclavicular region and mediastinal lymph nodes may be indicated.
In most cases, in the first stage, seminoma stops progressing after several courses of radiation therapy. But according to statistics, in 5% of patients the tumor continues to grow. Then combination chemotherapy with (platinum) is used.
Second stage
Tumor growth and development of metastases in the lymph nodes (retroperitoneal). Treatment at the second stage depends on the size and number of metastases. If the patient has formations smaller than five centimeters, then most often a radiation method of therapeutic treatment is prescribed to the inguinal and iliac lymph nodes. After completing the course of treatment, relapses occur only in rare cases.
Removal operation
At the third stage of development, seminoma is treatable, but its spread already affects several types of lymph nodes and internal organs. In order to cope with the main tumor and metastasis, it is necessary to undergo courses of chemotherapy. The duration of the full course is determined individually. In most cases, the patient needs to undergo four courses of chemotherapy, spaced three weeks apart.
In this case, the tumor may spontaneously shrink or disappear. A similar treatment outcome is observed in 70% of patients. In some patients with large metastases, residual tumor masses may remain, leading to relapse. Surgery to remove seminoma is indicated in only 15% of patients with residual tumor mass.
Fourth stage
The last stage is considered the most dangerous, since in most cases it is not operable. Chemotherapy and additional treatment are carried out to maintain the patient's life. Surgical intervention is performed in exceptional cases. At the fourth stage, too large an area is affected by metastases.
Treatment of the last stage of tumor progression is carried out in accordance with all methods of cancer treatment, including taking narcotic painkillers and undergoing chemotherapy. The patient's life expectancy depends on many factors.
Forecast
Seminoma is a dangerous form of the disease. However, with proper treatment, the likelihood of tumor resorption is high. Repeated therapy is carried out in case of relapse or detection of tumor markers.
All patients diagnosed with seminoma should be regularly monitored by a doctor for five years. This is the period allotted for the probability re-development diseases. According to statistics, relapse is detected in only 10% of patients. In order to increase the chances of recovery, it is necessary to undergo regular examinations with a doctor, consult specialists and not self-medicate.
On average, the prognosis for survival with seminoma is not so favorable if there is cancerous tumor. The five-year survival rate according to statistics is only 40%. In a benign form – from 90%. These data indicate general situation, these figures cannot be applied to an individual case.
The earlier a tumor is detected in a person’s body, the greater the chance of a long and fulfilling life. Seminoma can be detected by examination by a urologist, who should be visited at least once every six months. It is an examination by a specialist that can help to identify a progressive disease in time.
If there is pathology, you should not resort to use. Alternative medicine can only be used with the permission of a doctor and not harmfully drug treatment. Even in the absence of positive results, there is no need to reject medical methods. Elimination of such a dangerous disease as testicular seminoma should be carried out by qualified specialists with experience in dealing with pathologies of the human body.
May 25, 2016 Violetta Doctor
Seminoma (germiogenic) is a malignant testicular tumor. This type of tumor most often occurs in men aged 20 to 40 years and after 60.
Much less often, testicular seminoma can develop in children before the age of 10. Malignant germinal formations are registered in almost 100% of patients.
Of all germ cell tumors, seminoma accounts for approximately 40%. This type of malignancy usually develops on one side of the scrotum. They manifest themselves as a painless increase in the size of the testicle.
Tumors are divided into two large groups: germinal and non-germinative. Testicular seminoma begins to metastasize early, mainly spreading through the lymphatic vessels and developing in the lymph nodes. Initially in nearby areas (paraortic, inguinal), then in more distant areas (supraclavicular region, mediastinum).
Reasons for development
Today, doctors believe that seminoma develops depending on two main factors:
- cryptorchidism - failure of the testicle to descend into the scrotum;
- a hormonal imbalance in the male body, as a result of which the patient may develop testicular atrophy.
Injuries in the scrotum area can also contribute to the development of this disease.
Symptoms
At the initial stage, seminoma usually manifests itself only as enlargement and thickening. As a result of an increase in the size of the tumor, the patient may experience some pain in the abdomen and a feeling of heaviness in the affected testicle. If cryptorchidism is diagnosed, then the only thing that may indicate a tumor is a seminoma in the abdominal area. In some cases, general symptoms may predominate:
- violation of potency;
- hormonal disorders;
- premature puberty;
- gynecomastia, etc.
On initial stage Tumor growth is typical only within the testicle. At this stage, metastases are not observed. If metastases begin to appear in the area of the lymph nodes located behind the peritoneum, then the symptoms of the disease become more noticeable. The patient periodically experiences severe pain in the lumbar region.
When metastases spread to the lungs, a cough with bloody discharge begins to occur.
Diagnosis
The simplest way to diagnose a tumor is a visual examination of the scrotum. Already with its help you can get the first information. If the patient does not have cryptorchidism, but at the same time the asymmetry of the scrotum is clearly visible, then palpation is performed. This technique provides very valuable information for the surgeon. Due to testicular tumors, fluid often accumulates between their membranes. If necessary, the doctor performs a puncture to remove it. Then he palpates the scrotum.
An important role in diagnosing testicular tumor diseases is played by ultrasound diagnostics. It helps to more accurately determine the size and examine the internal structure of the tumor in more detail.
An x-ray can only reveal the presence of metastases. Therefore, in addition to x-ray diagnostic methods, excretory urography is performed. This is a method that allows you to examine the condition of the kidneys and urinary tract by injecting a radiopaque contrast agent into the blood and then taking a series of x-rays.
The most reliable method to find out whether it is a seminoma or not is a puncture biopsy with cytological examination.
Treatment methods
In most cases, seminoma is treated with surgery. It involves removing the affected testicle (hemicastration). For mature seminoma, this operation is usually sufficient.
If not, then the entire spermatic cord has to be removed. When establishing the presence of metastases in the lymph nodes of the retroperitoneal space, a different operation (lymphadenectomy) is used.
Simple or extended hemicastration is one of the first steps in the treatment of testicular seminoma. Then you need to carry out radiation therapy. This type of treatment will be positive for seminomas and tumors that include elements of seminoma. If the seminoma is quite large in size, then irradiation is carried out before the operation. After radiation, the size of the tumor is often so reduced that it becomes possible to remove it.
Radiation therapy is also used in the treatment of metastases, especially in the form of irradiation of a conglomerate of lymph nodes. Even when they cannot be removed.
Chemotherapy is also widely used in the treatment of malignant testicular tumors, especially if it is seminoma.
Regarding the prognosis for treatment of testicular seminoma, it all depends on the degree of the disease at which treatment was started. The adequacy of the therapeutic procedures performed also plays an important role.
Regular visits to a urologist allow you to identify the disease, as well as changes that can cause malignant degeneration of testicular tissue in the early stages, which significantly increases the chance of a full recovery.
Testicular seminoma is one of the types of malignant tumors of the male genital organs (testicles). It develops from embryonic cells that form testicular tissue and is also called testicular cancer.
Testicular seminoma is a type of testicular cancer.
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The disease occurs infrequently. Testicular cancer accounts for about 2% of malignant tumors affecting men. However, there is an increasing trend over the past decades, which causes serious concern among doctors.
Mostly men aged 20-40 years are affected. Patients over 60 years of age are less likely to suffer from seminoma, but sometimes it also occurs in children.
The reasons for the development of testicular seminoma, like any malignant tumor, are completely unknown. Among the predisposing factors, the most significant are heredity and (undescended testicle into the scrotum during embryonic development). A number of patients had a history of genital trauma and endocrine pathologies.
Symptoms and course
With seminoma, there is pain, swelling and an increase in the size of the testicle.
Clinical manifestations of testicular seminoma depend on the stage of the disease.
In the initial period, patients independently detect compaction of the testicle and the presence of a hard formation on it. Subsequently, swelling of the testicle and an increase in size appear.
As the disease progresses, pain appears in the back. This is due to the spread of metastases to regional lymph nodes. They can develop due to compression of the veins. Significantly enlarged metastatic conglomerates in the groin can sometimes compress the ureter, leading to. Distant metastases usually affect the lungs. This is accompanied by coughing up blood and shortness of breath. If metastases have spread to the liver, then jaundice, pain in the right hypochondrium, and ascites (fluid in the abdominal cavity) develop. When metastases are localized in the bones, intense aching pain appears in them.
Typical symptoms of cancer intoxication, characteristic of any type of oncology - general weakness, weight loss, asthenia, lethargy, are also typical for testicular seminoma, especially as it progresses.
Classification of testicular seminoma by disease stages
- Stage 1 - the tumor is localized, the testicle is not enlarged, there is no compaction or swelling.
- Stage 2 - damage to testicular tissues joins the tumor, with the development of edema, hardening and changes in the shape of the testicle.
- Stage 3 - the above changes are accompanied by damage to local lymph nodes.
- Stage 4 - metastasis damage to distant organs and systems of the body.
Diagnostics
Upon palpation of the testicle, seminoma is defined as a dense formation.
Diagnosis of seminoma begins with the correct interpretation of the patient’s complaints and examination by a doctor. Upon palpation, a dense formation is determined, fused with the testicular tissue.
Typically, the size of seminoma is 5-8 cm, and the tumor is well visualized using ultrasound. confirms the morphological component of the tumor.
In a special blood test, specific tumor markers are found - alpha-fetoprotein and beta-chorionic gonadotropin, etc. This is important for very small tumors, when the tumor is almost invisible.
In order to understand whether the cancer has spread to regional lymph nodes and further to vital organs, it is necessary to conduct a number of additional studies. The most informative is computed tomography, which shows the lymph nodes of the groin, peritoneum and mediastinum affected by metastases. The diagnosis can also be made by plain radiography of the abdominal and thoracic cavity. The latter helps to see metastases in the lungs.
The most sensitive diagnostic method is positron emission tomography, which accurately determines the stage of the disease.
Treatment
In the treatment of testicular seminoma, the basic principles used in the treatment of oncological diseases are adhered to.
The first step is surgery to remove the tumor. Most often, the entire testicle is excised along with the spermatic cord. If regional and retroperitoneal lymph nodes are affected, then they are also excised. Next, radiation and chemotherapy are carried out to finally suppress the growth of tumor cells. The choice of postoperative therapy depends on the extent of the process and the depth of damage to organs and systems.
In the early stages of the disease, radiation therapy to the inguinal and retroperitoneal region can be completely limited. In case of extensive development of cancer and in case of ineffectiveness of the treatment (threat of further development of metastasis), several courses of chemotherapy are used.
Sometimes the tumor spreads to the second testicle. In this case, surgeons use. As a result, the patient develops a decrease in the level of testosterone, which is produced in the testicles, which requires constant.
Testicular seminoma, as already mentioned, often occurs in young patients who have not yet had children of their own. In addition, seminoma can occur even in childhood. In such cases, if the disease is detected at an early stage and the tumor is clearly localized, organ-preserving surgery is performed, i.e., the tumor is excised while preserving the testicle. In this case, increased vigilance is necessary when monitoring the patient for the possibility of relapse.
It should be noted that there is no need to be afraid of having a testicle removed. The remaining testicle, as a rule, takes on the functions of. Most patients have a normal sex life after surgery and their sperm remain fertile.
Prevention
Timely treatment of cryptorchidism is the prevention of the development of cancer.
Speaking about the prevention of primary testicular seminoma, you should pay attention to the timely treatment of cryptorchidism. Patients who have undergone surgery to descend the testicle into the scrotum require close monitoring throughout their lives, since, according to statistics, it is they who most often develop a tumor. You should also avoid injuries to the genital organs and treat inflammatory diseases of the genital area in a timely manner.
Patients who have undergone surgery to remove seminoma require constant monitoring. In the first year after discharge, a general examination is required, including blood tests for tumor markers, once every 2 months. In the second year, patients are observed at least once every three months. Next year - once a quarter. In the future, depending on the patient’s condition, the examination is carried out once every six months or less often.
Forecast
Stage 1. With early diagnosis and timely comprehensive treatment, the prognosis is quite favorable. Patients with the first stage of the disease after surgery, as a rule, fully recover (up to 95%) and lead a full life, including having children.
Stage 2. In the second stage of the disease, despite a generally favorable outcome, there remains a higher risk of relapse (15-20% of patients are at risk of getting sick again over the next five years). Such patients require close monitoring during this period.
Stage 3-4. The prognosis for the third and fourth stages depends on the size of the tumor, the prevalence of metastases and the degree of damage to vital organs and body systems.
Thus, the key to the patient’s recovery is the earliest diagnosis of the disease and timely correct treatment.
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Testicular seminomas are dangerous diseases that most often turn out to be malignant. This tumor contains germ cells that continuously develop. Most often, education is diagnosed in representatives of the male half of the age category from 20 to 40 years. However, medicine knows of cases where the disease affected children.
There are several groups of diseases that are believed to be capable of triggering the development of seminoma. Thus, at risk are patients who have had or have cryptorchidism, when the testicle, for various reasons, does not descend into the scrotum (more detailed information find out about the disease). In addition, men and boys with impaired hormonal levels And .
Seminomas are insidious diseases that may not manifest themselves at all for a long time.
In the initial stages, the disease practically does not manifest itself in any way and has no characteristic symptoms. Most often, seminoma is detected independently, when a man feels his genitals and discovers something incomprehensible.
In addition, over time, the testicle in which the tumor develops enlarges, and quite quickly. As this happens, pain begins, especially if a person tenses. But it cannot be said that it is the tumor that causes pain. Most likely they arise because the lesion affects the spermatic cords.
Another manifestation of the disease is that the structures of the testicle become very compacted, and their shape becomes deformed.
A man begins to feel any discomfort from the moment when the boundaries of the neoplasm extend beyond the scrotum. This already indicates a danger to the health and life of the patient.
Stages and treatment
Regardless of whether you are diagnosed with seminoma of the right testicle or seminoma of the left testicle, treatment should always be selected individually, taking into account all the characteristics of the body and the course of the disease. First of all, it is necessary to conduct a complete diagnosis of the patient in order to establish the stage of the disease. Based on the examination findings, the most appropriate therapy is prescribed.
Yes, when first stage the tumor affects only the testicle and is located within it. At this stage, metastasis is not observed in other human organs and systems. As a therapy, radiation treatment is usually used, which affects the lymph nodes of the groin and retroperitoneum. Ray dosage – 30 grams. Until recently, specialists used the practice of additional radiation to treat seminoma. However, today this is being abandoned. There are cases (about 5%) when preventive radiation therapy does not help, but, on the contrary, contributes to the progression of the disease. In these cases, combination treatment is used, which uses chemotherapy and platinum drugs.
At second stage Seminoma metastasizes to the retroperitoneal lymph nodes. In this case, therapy is selected depending on many indicators and, first of all, on the size of these metastases. So, if they are less than 5 cm, radiation therapy is performed. As practice shows, the number of relapses after it is about 5%. And in more than 95% of cases, patients live more than five years. When the size of diagnosed metastases exceeds five centimeters, the number of relapses increases to 25%. In these cases, chemotherapy is already indicated.
Third stage Seminoma is characterized by metastasis to the lymph nodes above the diaphragm. Treatment is selected strictly individually.
There are cases in which induction chemotherapy cannot be avoided. It includes at least four treatment courses, which are repeated with a break of three weeks.
After treatment, especially if the tumor was large or had multiple metastases, the patient long time is under medical supervision, constantly undergoing examinations in order to early detect relapses.
Prognosis of testicular seminoma
Prognosis for cure directly depends on the stage of the disease, its neglect and the adequacy of treatment. Patients themselves must also pay enough attention to their health, follow all the doctor’s instructions and recommendations, undergo medical examinations on time and go to the hospital with the slightest suspicion of developing the disease or its relapse.
Tumors appear on the testicles much more often than on other male genital organs. This disease is called seminoma. Of all cancer cases, men account for about 2%. In almost all cases, testicular tumors are malignant. They make up almost 99% of cases. Most often, malignant tumors appear in men during sexual activity, that is, between the ages of 20 and 40 years. However, neither children nor elderly men are immune from such phenomena.
Certain factors can trigger the disease. These include cryptorchidism, testicular atrophy and hormonal disorders. Cryptorchidism is a pathology in which the testicle does not descend into the scrotum. The degree of manifestation of the disease depends on the stage of its development.
Testicular tumor symptoms
Seminoma practically does not manifest itself in the initial stages. In most cases, a man discovers the first symptoms on his own by palpating the testicles. Lumps in the testicles of unknown origin are the first sign of the disease.
Gradually, the testicle in which the seminoma develops begins to increase in size, this happens quite quickly and noticeably. Along with the enlargement of the testicle, pain begins to appear, which is especially pronounced during physical stress.
The pain is caused not so much by the seminoma itself as by damage to the spermatic cord. In addition, the disease disrupts the structure of the testicles. The affected testicle becomes deformed, and its structure becomes denser.
Discomfort begins to bother a man already at the stage of tumor development when it extends beyond the scrotum. This is the main danger of the disease, since in the early stages it does not cause any concern and is very difficult to diagnose.
The more the tumor spreads, the greater the danger to the patient’s life the seminoma will pose. Therefore, it is very important to determine the stage of the disease as early as possible and begin appropriate treatment.
Stages of the disease and its treatment
Seminoma is treated taking into account the individual characteristics of the patient’s body and the course of the disease.
First of all, the doctor must conduct an in-depth examination of the man’s body to determine at what stage the disease is. Only after this can adequate therapy be prescribed.
Stage 1 is the least dangerous. In this case, the tumor affects only the testicle. Other organs and tissues of the body are not affected by metastases. Most often, radiation therapy is prescribed, which affects the lymph nodes of the groin and retroperitoneum. Today, supplemental radiation is rarely used, although until recently it was a common practice.
In some cases, prophylactic radiation can lead to completely the opposite result, and the disease will begin to progress. This happens in approximately every 20th case. If this happens, then specialists prescribe combination therapy, including chemotherapy and platinum drugs.
At stage 2 of development, metastasis to the retroperitoneal lymph nodes begins. Optimal therapy depends on several factors. When choosing treatment methods, the size of metastases is taken into account. If they are less than 5 cm, then, as a rule, radiation therapy is prescribed. In this case, the proportion of relapses is no more than 5%. All other patients live for at least another 5 years. If the size of metastases exceeds 5 cm, then chemotherapy is prescribed. The disease recurs in every 4th case.
If stage 3 seminoma is diagnosed, this means that the metastases have spread above the diaphragm. Treatment methods in in this case are selected based on the individual characteristics of the organism. In this case, possible complications and other factors are taken into account.
In some cases, induction chemotherapy is prescribed. At least 4 courses are conducted with a break of 3 weeks. If the disease spreads widely, the patient should be under constant medical supervision. In the hospital it will be possible to constantly examine the patient in order to identify the dynamics of the disease and detect possible relapses as early as possible.
Prognosis for patients with seminoma
Probability complete cure depends entirely on the stage at which the disease was discovered and its treatment began.
The likelihood of recovery is reduced in those patients who do not adhere to doctors' recommendations. At the slightest suspicion of the presence of the disease or its recurrence, you should seek medical help.
Complete cure can be achieved even in very advanced cases. It depends on many factors. Positive on general condition The patient is influenced by the support of loved ones and positive emotions.
To prevent the disease from progressing, you must regularly visit your doctor for routine examinations. You can periodically conduct a self-examination so that if you detect the slightest changes, contact a specialist. However, self-examination should not replace doctor's examinations.
Thus, seminoma is a serious disease, the treatment of which must begin as early as possible. Depending on the stage of development of the disease, different therapy may be prescribed.
Seminoma is life-threatening, but timely treatment, full compliance with the doctor’s recommendations and a positive attitude toward recovery will help the patient recover completely.
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