Testicular Tumors – Occurrence of Retroperitoneal Lymphadenomegaly at the Time of Diagnosis

Introduction: Testicular tumors account for approximately 1% of all malignancies in men, but the age of patients and its increasing incidence make this malignancy one of the leading oncological problems. In spite of the fact that the testicles are organs accessible for self-examination and the accessibility of ultrasound examination as the method of choice in diagnostics, these tumors are often detected in an advanced stage of the disease. Aim of the Study: The aim of this study is to evaluate the occurrence of advanced disease at the time of diagnosis of testicular germ cell tumors, through retrospective analysis. Patients and Methods: Our study examines patients with testicular germ cell tumor (seminomatous and non-seminomatous) according to numerous parameters - anamnesis with special emphasis on risk factors, clinical examination, laboratory analyses with tumor markers, and diagnostic imaging examinations (thorax, abdomen and pelvis CT scan). Before the specific treatment, spermiogram and semen cryopreservation were done for most patients, while in some cases additional diagnostics (MRI of the endocranium, skeletal scintigraphy) was indicated as well. Results: During the observation period, 132 patients with testicular germ cell tumor were treated and observed, of which 58 patients (44%) with seminomatous tumor type and 74 patients (56%) with non-seminomatous tumors. Of the total number of patients, at the time of disease diagnosis, there were 41 patients (31%) with N1- N3 status of retroperitoneal lymph nodes and 17 patients (12.8%) with M1a-M1b metastatic status. Conclusion: A large number of newly detected testicular tumors are diagnosed in an advanced stage of the disease. It is necessary to raise awareness of the general population about this malignancy, emphasise the importance of self-examination in younger men, and promote the possibility of routine ultrasound examinations with the aim of early detection of the disease.