Testicular cancer

Testicular cancer (TC) is the most common neoplasia that occurs in males between 20-40 years old and it accounts for approximately 1–1.5% of all cancers in men . TC develops in testicles and includes several types of cancer, such as germ cell tumors (GCT), sex cord-gonadal stromal tumors and secondary testicular tumors. The incidence rate and mortality change considerably in different geographical areas: the rates are highest in Northern and Western Europe, Northern America and Australia, while lowest rates have been found in South Europe, Central America and, at last, in Asia and Africa . Over the last decades, the incidence of TC in western countries has been increasing, maybe because of an increased exposure to etiologic factors. Genetic and environmental factors play an important role in the genesis and development of TC; in fact, several genes are implicated in its pathogenesis and different environmental factors have been investigated. In the environmental agents there are pesticides and non-steroidal oestrogens, such as diethylstilboestrol

Causes

A major risk factor for the development of testis cancer is cryptorchidism. It is generally believed that the presence of a tumor contributes to cryptorchidism; when cryptorchidism occurs in conjunction with a tumor then the tumor tends to be large. Other risk factors include inguinal hernias, Klinefelter syndrome, and^[16] mumps orchitis Physical activity is associated with decreased risk and sedentary lifestyle is associated with increased risk. Early onset of male characteristics is associated with increased risk. These may reflect endogenous or environmental hormones.

Higher rates of testicular cancer in Western nations have been linked to the use of cannabis 

Scheme for tumors of male genital organs

Most testicular tumors (about 90–95%) arise from germ cells to generate the “GCT”, followed by gonadal stromal tumor (5–10%), mixed GCT and secondary tumors. The World Health Organization (WHO) recapitulates the classical histological entities of TCs in seminoma (SE) and nonseminoma (NS) hystotypes. SEs can be detected into three variants: classic, anaplastic and spermatocytes, whereas NSs include choriocarcinoma, embryonal carcinoma, teratoma and yolk sac tumors (YST). Testicular GCT may arise from a non-invasive form of disease named carcinoma in situ (CIS): under the microscope these cells appear abnormal although they have not yet spread outside the walls of the seminiferous tubules. CIS does not always degenerate in invasive cancer but it is very difficult to discover it because it often does not involve organ structures; a good way to diagnose CIS is to do a biopsy. When CIS becomes invasive, cancer cells spread either to the lymph nodes through either lymphatic or blood circulation.

Regards

Amalia Azzariti

Managing Editor

Journal of Clinical Oncology and Cancer Research