PARADIGMS AND CHALLENGES IN THE DIAGNOSIS AND TREATMENT OF TESTISAL NEOPLASM

Abstract

Testicular cancer is a malignant disease with a high incidence in young men, between 15 and 45 years old, and is considered the most common malignancy in this age group. Despite being a rare condition, it affects approximately 1% to 1.5% of the male population. However, it is also one of the malignant neoplasms with the highest cure rate, if diagnosed and treated early. This work discusses the challenges and paradigms in the diagnosis and treatment of testicular cancer, based on the experience of 15 cases assisted at Santa Casa de Misericórdia Dona Carolina Malheiros, from 2017 to 2022. The methodology used was descriptive, including the analysis of histopathological results. Patients were diagnosed through physical examination, scrotum ultrasound and tumor markers, and subsequently staged with abdominal and thoracic tomography. The majority of cases were found to have germ cell tumors, including classic seminomas, mixed germ cell tumors, and pure embryonal carcinoma. Classic seminomas were treated by postoperative observation, while cases of mixed germ cell tumors and embryonal carcinoma were referred to oncology for chemotherapy or follow-up. Some cases with extratesticular lesions and larger initial tumors were referred for oncological surgery. It was observed that early diagnosis is essential for therapeutic success, since cases with larger masses presented metastases. Therefore, the diagnosis of testicular neoplasia remains a medical challenge due to the social and psychological impact it has on young patients.