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SOP Bulletin 179

 ICD Coding:

• ICD-9-CM Codes:186, 187.5, 187.6
• ICD-10-AM Codes: C62, C63.0, C63.1

Brief description

Testicular cancer is the most common solid cancer in males between ages 15 and 35.  The SOP covers primary malignant neoplasms of both the testicle and paratesticular tissues. The paratesticular tissues include the epididymis, rete testis and vas deferens (spermatic cord), but not the tunica vaginalis of the testis, nor the bladder, urethra or penis.

Confirming the diagnosis

Diagnosis requires histopathology from a biopsy or excised lesion. 

The relevant medical specialist is a urologist or oncologist.

Additional diagnoses covered by SOP

• Malignant neoplasm of the epididymis
• Malignant neoplasm of the rete testis
• Malignant neoplasm of the spermatic cord

Conditions excluded from SOP

• Malignant neoplasm of the bladder*
• Malignant neoplasm of the penis* - non-melanotic malignant neoplasm of the skin SOP
• Malignant neoplasm of the scrotum* - non-melanotic malignant neoplasm of the skin SOP
• Malignant neoplasm of the seminal vesicles^#
• Malignant neoplasm of the urethra*
• Secondary neoplasms (metastases) to the testes or paratesticular tissues
• Hodgkin’s lymphoma*
• Non-Hodgkin lymphoma*
• Soft tissue sarcoma*

* another SOP applies

^# Non-SOP condition

Clinical onset

The usual presentation is with a painless mass involving one testicle.  Other manifestations may be: a dull ache or heavy sensation in the lower abdomen, perianal area, or scrotum; acute testicular pain; or manifestations of metastatic disease.

Clinical worsening

The only SOP worsening factor is for inability to obtain appropriate clinical management.  The condition is one of the most curable of solid organ cancers, with a five year survival rate of over 95%.  Prompt diagnosis and treatment provide the best opportunity for cure.