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Diagnosis, staging, and natural history of testicular tumors

Testis tumors are uncommon and most occur between the ages of 20 to 35 years. With rare exception they are malignant. Probably 35% of patients have metastasis when they are first seen. The most common finding is a painless enlargement of the testis. Delay in treatment can be overcome with education of patients and physicians. All testis masses must be considered malignant until proven otherwise. A high inguinal orchiectomy permits a histologic diagnosis and in many instances is curative. Evidence, of metastasis is sought out by selected studies. A scalene node biopsy is performed in all Stage II patients as 16% will be proven to be Stage III.1 The histologic diagnosis along with the clinical staging of the tumor will dictate the plan for further therapeutic management.