What Kinds of Cancer Can Develop in the Testicles?

A Concise Guide to Testicular Cancer Subtypes

Not all testicular cancers are the same...

Not all testicular cancers are the same. Testicular cancer can have many different sub-types depending on the cells from which they originate. The type of cancer may determine which signs and symptoms are present. Although it is not typically known in most cases what causes testicular cancer, there are certain risk factors which increase the risk of developing the cancer. Treatment for testicular cancer is typically based on surgery accompanied by radiation or chemotherapy.


             G E R M   C E L L   C A N C E R S   O F   T H E   T E S T I C L E S

Around 95% of all cases of testicular cancer come from what are known as germ cells. The reproductive cells (sperm and eggs) of the human body are derived from germ cells. As such, all the germ cell cancer types mentioned below will have a nonmalignant counterpart of the reproductive system, such as the sperm, the placenta and yolk sac. 

The development of germ cell cancer involves primordial germ cells that fail to differentiate (mature) correctly into normal cells and become malignant cells instead. Seminomas originate from the spermatogonial stem cell population, the same system that produces sperm. Nonseminomas are derived from embryonal stem cells that can differentiate into extraembyonic tissues.

It is very important to note that around one-third of germ cell tumors are mixed.

This means that a single tumor may be comprised of multiple cancer types. As an example, a tumor may contain both components of seminoma and choriocarcinoma. Some cancer types have a certain blood test, known as a tumor marker, which may be abnormal.

                                               -S E M I N O M A S-


  • 50% of all testicular germ cell cancers.

  • Nonmalignant counterpart: Spermatocyte. Sperm cells come from spermatocytes.
  • Associated tumor marker: hCG.
  • Characteristics: Compared to many other testicular cancers, it tends to occur in slightly older age groups, with 40 being the average age at time of diagnosis. It tends to present as a large tumor and is less aggressive in spreading. About 75% of new cases have no spread outside of the testicle itself. It is very sensitive to radiation therapy. It is oftentimes found with other non-seminoma type germ cell cancers, which are listed below. More on how testicular cancer spreads and is staged can be found here.

Spermatocytic seminoma

  • This is a rare subtype of seminoma (4% of seminomas) and occurs later in life, typically after the age of 50. Unlike seminoma, it is rarely mixed with other testicular cancer types.

                                         -N O N - S E M I N O M A S-


  • Nonmalignant counterpart: Embryonic cells. Associated with cartilage, glandular and glial tissue.
  • Associated tumor marker: None.
  • Characteristics: It does not normally have the potential to spread by itself, but may spread when accompanied by other germ cell cancer types. If it does spread with the other cancers, it typically is not cured by chemotherapy alone, but needs to be surgically removed. Rarely it is able to have a malignant transformation, where it further mutates to become more aggressive and spread without any other cancerous elements.

Embryonal cell carcinoma

  • About 2% of all testicular germ cell cancers although it is found in about 85% all all mixed type testicular germ cell cancers, especially yolk sac.
  • Nonmalignant counterpart: Early embryonic cells.
  • Associated tumor marker: hCG. Some sources state that AFP may be elevated.
  • Characteristics: Average age at diagnosis is 30. 


  • Less than 0.5% of all testicular cancers by itself (i.e. pure choriocarcinoma). However, it is found in about 10% of mixed cell germ tumors.
  • Nonmalignant counterpart: Placental cells.
  • Associated tumor marker: hCG (typically very elevated).
  • Characteristics: This is the most aggressive form of germ cell cancer and tends to spread early. This is one of the few testicular cancers that may spread via the blood vessels rather than through lymphatic channels.

Yolk sac tumor

  • It is found in about 40% of mixed germ cell tumors.
  • Nonmalignant counterpart: Yolk sac
  • Associated tumor marker: AFP is almost always elevated. 
  • Characteristics: May also be known as an endodermal sinus tumor. Most common in childhood. As a matter of fact, it is the most common germ cell cancer before puberty. It tends to be fairly unaggressive. ​


                             S E X   C O R D - S T R O M A L   T U M O R S

These types account for less than 3% of testicular cancers. Similar to the germ cell cancers, they may also be mixed with other testicular cancer types.

Leydig cell tumors

  • Most common sex cord stromal tumor.
  • Nonmalignant counterpart: Leydig cells. Leydig cells are the cells in the testicles responsible for producing the hormone testosterone. 
  • Associated tumor marker: None.
  • Characteristics: Most commonly occur between 40-50 years of age. They typically respond poorly to chemotherapy. May also produce estrogen resulting in decreased sex drive, erectile dysfunction and increased breast tissue (gynecomastia).

Sertoli cell tumors

  • Nonmalignant counterpart: Sertoli cells. Sertoli cells support the maturation and development of sperm in the testicles.
  • Associated tumor marker: None.
  • Characteristics: Unlike Leydig cell tumors, it may respond to certain types of chemotherapy. 

Granulosa cell tumors

  • Associated tumor marker: None.
  • Characteristics: Tends to not be aggressive and is associated with a good prognosis in most cases.


                                 P A R A T E S T I C U L A R   C A N C E R S

These cancers are extremely rare.

  • Malignant mesothelioma of the tunica vaginalis: The tunica vaginalis is the tissue that encases each testicle. 
  • Rhabdomyosarcoma: Derived from connective tissues around the testicle.  ​Uses occurs before the age of 20. Spread to lymph nodes and lungs is not uncommon.
  • Adenocarcinoma of the rete testis: This is a glandular tissue cancer which arises from the rete testis, which transports sperm from the seminiferous tubules to the vas deferens. 
  • Serous carcinoma
  • Endometroid adenocarcinoma


                               W H I T E   B L O O D   C E L L   T U M O R S

Once again, these cancer types are extremely rare.

  • Primary testicular lymphoma: This is the most common cause of a testicular mass in men ages greater than 60. It is highly aggressive and tends to spread to the marrow, central nervous system (brain) and the lungs. However, it is treatable and potentially curable with current chemotherapy regimens.
  • Acute lymphoblastic leukemia: The testicles are involved in around 5% of boys with this leukemia.
  • Promeylocytic leukemia: Rarely will adults with this leukemia have testicular involvement.
  • Primary testicular plasmacytoma: Extremely rare tumor of the testicles derived from a type of white blood cell known as a plasma cell.


    O T H E R   C A N C E R S   T H A T   M A Y   S P R E A D   T O                                                                T H E   T E S T I C L E S

Certain cancers, which originated elsewhere, are able to spread (metastasize) to the testicles. Both prostate and lung cancers are capable of this, although it is considered a rare event.

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