Case report on testicular cancer

Mounika1, Sagaya Selvi2, Esthar Rani3*

1Nursing Incharge, Kauvery Hospital, Tennur, Trichy, Tamil Nadu

2Assistant Nursing Superintendent, Kauvery Hospital, Tennur, Trichy, Tamil Nadu

3Nursing Superintendent, Kauvery Hospital, Tennur, Trichy, Tamil Nadu

Case Presentation

A 31years male presented with painful back, Enlarged Scrotum, since 1 year.

They visited Ishwarya hospital and underwent a scrotal ultrasound investigation, which revealed the presence of a scrotal nodule. After reviewing the report, they proceeded to Sree Pudukottai Hospital for further urology consultation. The urologist examined the patient and recommended an MRI scan. The scan was performed, and it revealed a large, well-defined solid-cystic mass lesion in the right scrotal sac involving the right testis, measuring approximately. (size to be mentioned 6.6*5.4*4.5cm (CC*TR*AP)

The patient was examined at GVN Hospital, where a CT Scan chest has done and the patient was admitted for further evaluation and management of a testicular mass.

An opinion was obtained from the interventional radiologist, and a left supraclavicular lymph node biopsy was planned. After obtaining informed consent, an ultrasound-guided trucut biopsy was performed, which revealed a malignant infiltrate. Suggestive of a metastatic germ cell tumor (cicely seminoma). The doctor advised inj. clexane S/C and oral analgesics.

A multidisciplinary (MDT) discussion was conducted, and the nature of the discourse along with its poor prognosis was cleanly explained to the patient’s attenders.  It was planned to initiate four cycle of chemotherapy followed by an interval orchidectomy.

The attenders were not willing to proceed with treatment at this point and requested time to decide.  Hence the patient was discharged with oral anticocugulation (Tab. Eliquis)

Next the patient came to kauvery hospital and consulted medical oncologist. Oncologist examined the patient advised some blood test (CBC, ZFI, RFT) and reviewed the previous test reports and then she stated that the patient need to undergo chemotherapy. The patient was admitted and received the first cycle of chemotherapy for 5 days.

  • Etoposide 200mg for 5 Days
  • Potarsicumchdoride 20mcq + Inj.Magnesium Sulphate 1 gm for 5 Days
  • Cisplatine was administered 40mg for 5 Days
  • Bleomycin 30Units for one day

Premedication was given prior to chemotherapy.

After completing the first cycle of 5 days chemotherapy the patient was discharged in good condition. The next cycle will be given in 21 days.

Follow up Outcome

  • We educated the patient and their attendant to follow balanced diet.
  • We educated the patient on maintaining proper personal hygiene, emphasizing the importance of regular bathing.
  • Encourage young men to aware of their body.
  • Do regular self-exams and report any change immediately
  • To encourage the regular exercise and avoid smoking and excessive alcohol intake

Conclusion

Testicular cancer is a highly treatable disease, particularly when detected early with over case 5-year survival rates exceeding 95% early detection through awareness and self-exams is crucial for maximizing chances of care.  Treatment options including surgery, chemotherapy, and radiation are often successful even in advanced stages, with survival rates of 70-80% or higher.

References

  • StatPearls-Testicular Cancer-Shiva Jashwanth Gaddam; Fuat Bicer; Gregory T. Chesnut
  • Williamson SR, Delahunt B, Magi-Galluzzi C, Algaba F, Egevad L, Ulbright TM, et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel.
  • Chung P, Warde P. Testicular cancer: germ cell tumours. BMJ Clin Evid 2016; 2016.

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