Initial management of testicular germ cell tumours

This includes:

♦ Ultrasound of both testicles

♦ Blood levels of the testicular tumour markers (AFP, HCG, LDH) Where the patient has obvious and widespread metastases, immediate referral for chemotherapy may be necessary, but in general the initial management will be inguinal orchidectomy. A biopsy of the contralateral testis should be considered where there is a high risk of carcinoma in situ. Such patients include those with a history of maldescent, a small testis (less than 12 ml), and patients less than 30 years. Further staging investigations will usually be performed post-operatively.

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