Internal Medicine

0521779407-20 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 21:22

Tension-Type Headache Testis Tumors 1409

Treatment options

■Abortive agents

➣Acetaminophen

➣Aspirin

➣Ibuprofen

■Prophylactic agents

➣Tricyclic antidepressants

Amitriptyline

Nortriptyline

Doxepin

➣Botulinum toxin

follow-up

■Every 3–12 months depending on level of control

complications and prognosis

■Good

TESTIS TUMORS

ARTHUR I. SAGALOWSKY, MD

history & physical

■the most common male cancer ages 15–35 years

■cryptorchidism risk ratio for tumor 3–14×normal; contralateral

testis also at increased risk

■Primary testis tumors: 5 most common histologies:

➣seminoma 40%

➣teratocarcinoma 25–30%

➣embryonal carcinoma 20–25%

➣teratoma 5–10%

➣choriocarcinoma 1%

Symptoms & Signs

■painless or painful testis mass

■testis may feel heavy

■often first noticed after minor trauma, so-called “trauma decoy”

■may have reactive epididymitis, orchitis, or hydrocele due to sudden

tumor growth or blood

■any solid testis mass should be considered a germ cell tumor until

proven otherwise