Testicular Tumor

　　The incidence of testicular tumors is extremely low, about 1 in 50,000. Among the malignant testicular tumors that occur, the incidence of contralateral testicular tumors is 1.2% to 5.8%. Some people believe that due to the application of platinum-containing chemotherapy regimens in the past 10 years, the cure rate of testicular tumors has increased and the survival period has been prolonged, leading to an increasing tendency in the incidence of second primary testicular tumors.

　　In simultaneous or non-simultaneous bilateral testicular tumors, the pathological type is predominantly spermatocytic, while other germ cell tumors are rare. Non-simultaneous bilateral testicular tumors occur at an older age, with 1.8% of patients occurring in those over 45 years old, which may be related to the fact that patients with spermatocytic tumors are easily cured by radiotherapy or chemotherapy, with prolonged survival. Cryptorchidism is considered a risk factor for testicular tumors, with a three to four times higher chance of developing tumors than normal testicles. Up to 7% to 10% of testicular tumors occur in cryptorchidism. It has been observed that surgery after the age of 10 cannot prevent the occurrence of tumors, surgery before the age of 10 can significantly reduce the chance, and surgery before the age of 3 can avoid the occurrence of tumors. In addition, testicular tumors are also related to heredity, polyglandularism, atrophy of the testicle due to trauma, hormones, and other factors.

　　In addition to causing changes in the testicle itself, testicular tumors can also cause some other diseases, the most common of which are the following three.

　　1. Testicular torsion

　　Testicular torsion is one of the common complications of testicular tumors. Testicular tumors can change the shape of the testicle, and under the stimulation of strenuous exercise, trauma, and other factors, it can cause the retractor testicular muscle fibers to present a spiral shape, combined with the weight of the testicle, especially for cryptorchid patients with only one exposed testicle, which is more prone to this disease. Therefore, patients with testicular tumors should avoid strenuous exercise as much as possible.

　　2. Varicocele

　　It is not uncommon for patients with testicular tumors to have varicocele, which is caused by the stasis of spermatic vein blood, resulting in the expansion, tortuosity, and elongation of the venous plexus. Varicocele may lead to testicular atrophy and spermatozoal天生障碍, causing infertility. The occurrence of varicocele in patients with testicular tumors is often related to the early metastasis of the tumor, so patients with testicular tumors should be treated as soon as possible.

　　3. Epididymitis

　　The posterior margin of the testicle is the epididymis, where sperm are temporarily stored after production. Epididymitis is more common in people around 30 years old, mostly due to testicular deformity and bacterial infection, causing bacteria to enter the epididymis through the lumen of the vas deferens. Orchitis is often caused by the direct spread of epididymitis to the testicle due to testicular deformity, and is caused by bacteria. In addition to the transfer of testicular physiological morphology and function, immune function and other factors may also be affected in patients with testicular tumors, which increases the chance of infection and is prone to complications such as epididymitis.

　　This disease commonly occurs in young and middle-aged adults aged 20 to 40, with variable clinical symptoms. It may be asymptomatic and often discovered incidentally. As the mass gradually increases, a sense of descent or weight may occur; a few patients may have local skin redness, pain, and other symptoms; inguinal hernia patients may present with a mass in the lower abdomen of the inguinal region; in the late stage, symptoms such as pain in the bones and joints, cough, and dyspnea at the corresponding metastatic sites may occur. During physical examination, the testicles may be enlarged, firm, and heavy, losing normal elasticity; the mass is closely related to the testicle, with unclear boundaries and a smooth surface or several large nodules; a few patients with testicular tumors secreting HCG may have breast enlargement.

　　A detailed and complete medical history and a careful physical examination are important for diagnosis. In addition to local examination of the testicular mass, a systemic examination of the whole body should also be performed to understand whether there are metastatic lesions. Testicular tumor is禁忌 puncture biopsy to avoid tumor spread.

　　There are many causes of testicular tumor, among which the improper treatment of testicular diseases such as cryptorchidism, acute orchitis, and testicular trauma, leading to testicular atrophy and cell变性, is the main cause of testicular tumor. Therefore, actively treating these diseases can effectively prevent the occurrence of testicular tumor.

　　1. Cryptorchidism

　　Cryptorchidism is the most common congenital factor leading to testicular tumor. As age increases, the incidence of malignant tumors caused by cryptorchidism also increases. Among them, the incidence of malignant tumors in patients with cryptorchidism accounts for 8-15%, including testicular tumors. Therefore, patients with cryptorchidism should receive medication or surgical treatment as soon as possible to lower the testicle to the normal position.

　　2. Acute orchitis

　　Orchitis is the most common testicular infectious disease, characterized by symptoms such as testicular enlargement and pain. If acute orchitis is not treated properly, it may turn into chronic orchitis, leading to long-term stimulation of the testicle by inflammatory cells, causing abnormal cell proliferation, which may lead to testicular tumor.

　　3. Testicular trauma

　　For mild testicular trauma, such as contusion, the testicular function can generally be restored through conservative treatment. However, if the testicular injury is severe, such as serious laceration, even if testicular repair is performed, the shape, blood supply, and function of the testicle cannot be restored. But if the testicle is not removed, the damaged testicle left in the body is equivalent to planting a time bomb. This is because it may cause testicular atrophy and cell变性, which is exactly the cause of testicular tumor.

　  When diagnosing testicular tumor, in addition to relying on its clinical manifestations, auxiliary examinations are also needed. The main examination methods include ultrasound, chest X-ray, CT, MRI, PET, placental alkaline phosphatase, human chorionic gonadotropin, alpha-fetoprotein, lactate dehydrogenase

　　It is recommended to eat food

　　①It is recommended to eat more foods that can prevent testicular tumor: turtle, cat meat, kelp, sparrow, crucian carp, pig urinary bladder, buckwheat, walnuts, lychees, hawthorn, luffa, lettuce, and black plum.

　　②For women with obvious feminine symptoms, it is recommended to eat dog meat, dog penis, sea horse, shrimp, loach, scallops, turtle meat, walnuts, lamb, and lamb kidneys, as well as sparrow.

　　③For lower back pain, it is advisable to eat taro, chestnuts, plums, lychees, luffa, shrimp, abalone, red bean, sea horse, and jellyfish.

　　④It is recommended to eat vegetables such as rapeseed, bitter melon, dregs of tofu, loach, yellow perch, crab, and toon.

　　Avoid eating food

　　① Avoid smoking, drinking, and all spicy and stimulating foods.

　　② Avoid moldy, pickled, fried, and greasy foods.

　　③ Avoid warm and strong Yang foods such as mutton, dog meat, chives, animal tendons, etc. Testicular tumors are not common in clinical practice, but almost all are malignant. The age of onset has three peaks: in the neonatal period, there are more yolk sac tumors, in the middle-aged and young people, various types can be seen, and after 70 years old, it is mainly seminoma. The most common symptom of testicular tumors is painless enlargement and weight of the testicle. The enlarged testicle of seminoma often maintains the contour of the testicle and uniform texture. While teratoma presents nodular enlargement, soft and hard inhomogeneity.

　　Most testicular tumors are malignant tumors and need to be treated in a timely and standardized manner to extend the patient's survival period and improve the quality of life. The commonly used treatment methods for testicular tumors at present are as follows: Western medicine treatment of testicular tumors

　　1. Surgical Treatment

　　Orchiectomy includes radical orchiectomy and partial orchiectomy. Radical orchiectomy is suitable for patients with stage I seminoma; partial orchiectomy is suitable for patients with bilateral testicular tumors or solitary testicular tumors with normal testosterone levels and tumor volume less than 30% of the testicle. This procedure should be performed under strict indications because the incidence rate of testicular in situ carcinoma is as high as 82%. At the same time, it is generally required to undergo radiotherapy after surgery, which will affect the patient's reproductive function. Currently, this procedure is still in the exploratory stage.

　　2. Conservative Treatment

　　The conservative treatment methods for testicular tumors include radiotherapy and chemotherapy. Radiotherapy needs to be selected according to the condition and the dose of radiation; commonly used chemotherapy drugs include carboplatin, cisplatin, etoposide, bleomycin, etoposide, ifosfamide, paclitaxel, vincristine, etc., and one or more drugs need to be selected and used in combination according to the patient's condition. The side effects of radiotherapy and chemotherapy are significant, and supportive treatment such as nutritional support is also needed during the treatment process.

　　3. Comprehensive Treatment

　　Some patients with testicular tumors have already metastasized, and surgical treatment cannot completely remove the lesions. However, the metastasis is not severe, and the metastatic tumor cells can be killed by chemotherapy or radiotherapy. At this time, it is advisable to adopt comprehensive treatment methods, that is, to undergo radiotherapy or chemotherapy first, and then wait for the time to be ripe before undergoing surgical treatment.