TESTIS, CANCER OF
T
LOCATION OF THE TESTIS
Each testis is suspended in the
scrotum by a spermatic cord,
which contains the vas deferens,
and the arteries, veins and nerves
that supply the testis.
Prostate
gland
Vas deferens
Spermatic cord
Epididym is
Testis
Scrotum
Bladder
Seminal
vesicle
produced by both the mother and the
fetus, the testes gradually descend. At
birth, or w ithin the next few months,
they have usually reached the surface of
the body and hang suspended in the
pouch of skin called the
s c r o t u m
.
STRUCTURE
W ithin each testis are the seminiferous
tubules, delicate coiled tubes that pro-
duce sperm. These tubules lead via the
vasa efferentia (small ducts) to the
e p i-
d id y m is
,
a structure lying behind the
testis
in
w hich
the
newly
formed
sperm mature. Cells between the semi-
niferous tubules produce testosterone,
the male sex hormone, w hich passes
into small blood vessels in the testis
and then into the circulation.
Each testis is protected by a tough,
fibrous capsule, the tunica albuginea,
and is suspended from the body by the
s p e rm a t ic c o r d
.
This cord is composed of
the
va s d e fe re n s
(the tube that transports
sperm from the epididymis to the ure-
thra), and a number of blood vessels and
nerves. (See also
te stis, u n d e s c e n d e d
. )
te s tis , c a n c e r o f
A rare, cancerous tumour of the
t e s tis
.
Testicular cancer occurs most common-
ly in young to middle-aged men, and
the risk increases in individuals who
have a history of undescended testis
(see
te stis, u n d e s c e n d e d
) .
TYPES
The most common types of testicular
cancer are seminomas, which are made
up of only one type of cell, and
t e r-
a to m a s
,
w hich are made up of cells that
do not resemble other cells in the testis.
Other cancers affecting the testis are
extremely rare and develop from testic-
ular tissue or from lymphatic tissue
within the testis (see
ly m p h o m a
) .
SYMPTOMS
The cancer usually appears as a firm, pain-
less swelling of one testis. In some cases,
there may be pain and inflammation.
DIAGNOSIS
Men are recommended to examine their
testes regularly to check for unusual
changes (see
te s tic u la r s e lf-e x a m in a tio n
) .
If
a lump is found, the doctor w ill perform
tests,
such
as
u ltra s o u n d s c a n n in g ,
to
exclude other causes of testicular swelling
(see
testis, sw o lle n
) .
TREATMENT
B io p s y
,
followed by
o r c h id e c t o m y
(surgi-
cal removal of the testis) is the usual
course of action for testicular cancer,
and may be combined with
c h e m o t h e r-
a p y
.
The tumours usually respond well
to treatment. Provided the other testis is
healthy, treatment generally does not
destroy its fertility.
te s tis , e c to p ic
A
te s tis
that is absent from the
s c ro tu m
because it has descended into an abnor-
mal position, usually in the groin or at
the base of the penis. The condition is
most often discovered soon after birth
during a routine physical examination. It
is treated by
o r c h id o p e x y
,
an operation to
place the testis in the scrotum. (See also
te stis, u n d e s c e n d e d
. )
te s tis , p a in in th e
Pain in a
te s tis
may have a number of
causes, including m ild injury, a tear in
the wall of the testis due to a direct
blow,
o r c h it is
(inflammation
of
the
testis),
e p id id y m o -o rc h it is
(inflammation
of the testis and the epididymis), and
torsion of the testis (see
te stis, t o rs io n o f
) .
Sometimes, no cause is found and the
pain disappears without treatment. If the
wall of the testis is torn, an operation to
repair it may be needed.
te s tis , re tra c tile
A
te s tis
that is drawn up high into the
groin by a pronounced muscle reflex in
response to cold or touch. A retractile
testis is normal in young children, but
it usually disappears by
p u b e r t y
.
te s tis , s w o lle n
Swelling of the
te s tis
or surrounding tis-
sues in the
s c ro t u m .
Harmless, painless
swellings include
e p id id y m a l c y s ts, h y d ro -
c e le s , v a ric o c e le s ,
and
s p e rm a to c e le s .
Can-
cer of the testis (see
te s tis, c a n c e r o f)
is a
rare cause of swelling; swelling due to
a cancerous tumour is usually painless.
Painful swelling may be due to a direct
blow, torsion of the testis (see
te stis, to r-
s io n o f ) , o rc h it is
(inflammation of the
testis), or
e p id id y m o -o rc h it is
(inflamma-
tion of the testis and epididymis). Any
swelling of the testes should be assessed
promptly by a doctor. An
u lt ra s o u n d
scan
may be done to aid diagnosis.
te s tis , to rs io n o f
Twisting of the
s p e rm a tic c o rd
that causes
severe pain and swelling of the testis.The
pain develops rapidly and is sometimes
accompanied by abdominal pain and
nausea. The testis becomes swollen and
very tender, and the skin of the
s c ro tu m
becomes discoloured. Unless the torsion
is treated within a few hours, permanent
damage to the testis results. The con-
dition is most common around puberty.
It is more likely to occur if the testis is
unusually mobile within the scrotum.
TORSION OF THE TESTIS
If a testis rotates, veins in the
spermatic cord become obstructed,
causing severe swelling and pain. The
condition is most common around
puberty but can occur at any age.
Bladder
Spermatic
cord
Penis
Testis in normal
position in
scrotum
Spermatic
cord
twisted
Testis
turned
around
Treatment
Torsion must be treated bysurgery within a
few hours, otherwise the testis will have to
be removed. In surgery, both testes are
secured in the scrotum to prevent recurrence.
736
previous page 735 BMA A Z Family Medical Encyclopedia   2004 read online next page 737 BMA A Z Family Medical Encyclopedia   2004 read online Home Toggle text on/off