• Cryptorchidism or testicular maldescent
• Klinefelter's syndrome
• Family history
• Male infertility (increases risk of cancer).
• Low birth weight, young maternal age, young paternal age, multiparity, breech delivery
• Height - taller men are more at risk of developing germ cell tumours

Of all risk factors, cryptorchism and malignancy in the contralateral testis are by far the strongest

• A painless swelling of testis
• Change in shape or size of one testis compared to opposite side
• Feeling of heaviness in scrotum
• Dull aching dragging lower abdominal pain
• History of recent trauma (which made patient notice the symptom)
• Swelling in inguinal region

• Diagnosis is usually confirmed by ultrasound
• Tissue histopathology is done only after a high inguinal orchidectomy
• Disease can be staged by thoraco-abdominal CT scan or PET scan
• Elevation of tumour markers supports the diagnosis but normal marker levels do not exclude testicular cancer
• Alpha-fetoprotein (AFP) is produced by yolk sac elements but not produced by seminomas
• Beta-hCG may be elevated levels both in teratomas and in seminomas

All patients need to undergo High inguinal orchidectomy to diagnose the disease. Staging is done by CECT abdomen or PET CT. Further treatment depends upon stage of disease or based on histology (seminoma or non-seminoma).

Seminoma are radiotherapy and chemo sensitive and hence treated with chemotherapy / radiotherapy in advanced stages. Non-seminoma patients are treated with adjuvant chemotherapy and may need lymph nodal dissection in advanced cases

• Surgical options of High orchidectomy + Ilio inguinal Block dissection
• Adjuvant Chemotherapy and Radiotherapy whenever necessary
• Option of fertility preservation/ sperm banking available and offered to our patients
• Testicular implants if necessary