Testicular Cancer Case Studies A 21-year-old male noted pain in his right testicle while studying hard for his midterm college examinations. On self-examination, he noted a “grape sized” mass in the right testicle. This finding was corroborated by his healthcare provider. This young man had a history of delayed descent of his right testicle until the age of 1 year old. Studies Results Routine laboratory studies Within normal limits (WNL) Ultrasound the testicle Solid mass, right testicle associated with calcifications HCG (human chorionic gonadotropin) 550mIU/mL (normal: <5) CT scan of the abdomen Enlarged retroperitoneal lymph nodes CT scan of the chest Multiple pulmonary nodules Diagnostic Analysis At semester break, this young man underwent right orchiectomy. Pathology was compatible with embryonal cell carcinoma. CT directed biopsy of the most prominent pulmonary nodule indicated embryonal cell carcinoma, compatible with metastatic testicular carcinoma. During a leave of absence from college, and after banking his sperm, this young man underwent aggressive chemotherapy. Repeat testing 12 weeks after chemotherapy showed complete resolution of the pulmonary nodules and enlarged retroperitoneal lymph nodes. Critical Thinking Questions 1. What impact did an undescended testicle have on this young man’s risk for developing testicular cancer? 2. What might be the side effects of cytotoxic chemotherapy? 3. What was the purpose of preserving his sperm before chemotherapy? 4. Is this young man’s age typical for the development of testicular carcinoma?

Testicular Cancer Case Studies


Testicular cancer is a rare but highly treatable malignancy that primarily affects young males. In this case study, a 21-year-old male presented with pain in his right testicle, leading to the discovery of a mass. This paper aims to analyze the impact of an undescended testicle on the individual’s risk for developing testicular cancer, discuss the potential side effects of cytotoxic chemotherapy, explore the purpose of preserving sperm before chemotherapy, and evaluate the typical age for the development of testicular carcinoma.


1. Impact of an undescended testicle on the risk for developing testicular cancer

An undescended testicle, or cryptorchidism, occurs when one or both testicles fail to descend into the scrotum before birth. This condition is associated with an increased risk of testicular cancer. Studies have shown that individuals with a history of cryptorchidism are 2-8 times more likely to develop testicular cancer compared to those with normally descended testicles (Giwercman et al., 2016). The exact mechanism underlying this association is not well understood, but it is thought to be related to the abnormal development and function of the testicle in the undescended position.

In this case study, the patient had a history of delayed descent of his right testicle until the age of 1 year old. This likely contributed to his increased risk for developing testicular cancer. It is important to note that while cryptorchidism is a risk factor, the majority of individuals with undescended testicles do not develop testicular cancer. Nonetheless, regular surveillance and self-examination are recommended for individuals with a history of cryptorchidism to facilitate early detection and treatment.

2. Side effects of cytotoxic chemotherapy

Cytotoxic chemotherapy is a systemic treatment approach that uses drugs to target and kill cancer cells. While effective in eradicating cancer cells, cytotoxic chemotherapy can also result in several side effects due to its impact on rapidly dividing normal cells. Common side effects of chemotherapy include nausea, vomiting, hair loss, fatigue, and decreased blood cell counts.

In this case, the young man underwent aggressive chemotherapy after banking his sperm. The specific regimen used was not specified. However, it is important to note that different chemotherapy drugs have varying side effect profiles. Depending on the drugs used, the individual may experience additional side effects such as peripheral neuropathy, kidney damage, or secondary malignancies. Proper management of side effects is crucial to ensure the patient’s quality of life during and after chemotherapy.

3. Purpose of preserving sperm before chemotherapy

Preserving sperm before undergoing chemotherapy is important to address the potential fertility issues that may arise from the treatment. Cytotoxic chemotherapy can damage the sperm-producing cells in the testicles, leading to temporary or permanent infertility. By preserving sperm through sperm banking or cryopreservation, individuals can maintain the possibility of future biological parenthood. This is particularly relevant for young males who may desire to have children in the future.

In this case, the patient underwent sperm banking before chemotherapy. This decision reflects the understanding of the potential adverse effects of chemotherapy on fertility and the desire to mitigate these effects. Sperm banking allowed the individual to preserve his reproductive capacity and potentially pursue fertility options, such as in vitro fertilization, after completing treatment.

4. Typical age for the development of testicular carcinoma

Testicular carcinoma most commonly affects young males between the ages of 15 and 35, with a peak incidence in the third decade of life (Chia et al., 2016). In this case study, the patient developed testicular carcinoma at the age of 21, which falls within the typical age range. The exact cause of this age distribution is unknown, but hormonal and environmental factors may play a role.


This case study illustrates the impact of an undescended testicle on the risk of developing testicular cancer and emphasizes the importance of regular surveillance in individuals with cryptorchidism. It also highlights the potential side effects of cytotoxic chemotherapy and the significance of preserving sperm before treatment. Additionally, the case reinforces the typical age distribution of testicular carcinoma in young males. Understanding these aspects is essential in the diagnosis, management, and counseling of individuals with testicular cancer. Future research should aim to elucidate the underlying mechanisms of the associations discussed and explore novel treatment strategies to further improve outcomes for patients with testicular carcinoma.