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Oncology > 05a: Testicular/Prostate > Flashcards

05a: Testicular/Prostate Flashcards

1
Q

Cancers in the scrotum can arise from various tissues. List the different categories of tumors.

A
  1. Germ cell tumors (seminoma, nonseminoma)
  2. Sex cord-stromal
  3. Paratesticular
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2
Q

T/F: Testicular cancer is the most common cancer in the young adult/middle aged man.

A

True (20-34 yo) - but still a very rare cancer

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3
Q

T/F: Testicular cancer cannot occur before puberty

A

False

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4
Q

T/F: Testicular cancer is highly treatable with quite simple Rx.

A

False - highly curable, but complex Rx, need multi-disciplinary team

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5
Q

List some RFs for testicular cancer:

A
  1. Past Hx of testicular cancer
  2. FHx
  3. Kleinfelter’s or Down’s
  4. HIV/AIDS
  5. Heavy marijuana use
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6
Q

T/F: Testicular cancer most common in white males.

A

True

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7
Q

Most common initial presentation/Sx for testicular cancer:

A

Painless scrotal mass

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8
Q

List some Sx of advanced testicular cancer that patients may present with:

A
  1. Back pain (enlarged nodes)
  2. Gynecomastia (high hCG)
  3. Infertility
  4. Sx of metastasis (bone pain, kidney failure, neuro/liver issues, etc.)
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9
Q

List the lab markers checked for suspected testicular germ cell tumors

A
  1. LDH
  2. AFP
  3. Beta HCG
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10
Q

If testicular cancer is suspected based on lab work, what’s the next step?

A

Urgent scrotal ultrasound

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11
Q

Testicular cancers spread in (orderly/disorderly) pattern.

A

Orderly - 95% start in retroperitoneum

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12
Q

Testicular cancer imaging: urgent (X) used to assess scrotal mass. Which other imaging modalities would you order?

A

X = scrotal ultrasound

Abdominal/pelvic CT with contrast (assess retroperitoneum for cancer spread)

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13
Q

Patient with suspicious L testicular mass gets abdominal CT to assess for metastasis. Where is the first place you’d expect to find the mass if this was cancer?

A

L Para-aortic space (between aorta and kidney) - since L testicular vein drains into L renal artery

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14
Q

Patient with suspicious R testicular mass gets abdominal CT to assess for metastasis. Where is the first place you’d expect to find the mass if this was cancer?

A

Inter-aortocaval space (under renal vein) - since R testicular vein drains into IVC directly

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15
Q

Testicular cancer: what’s the step after cancer is confirmed by imaging?

A

Urgent urology consult

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16
Q

T/F: After imaging, testicular cancer is definitively diagnosed by biopsy.

A

False! NO scrotal biopsy done and inguinal approach for biopsy is rarely performed

17
Q

Testicular cancer: (X) procedure is both diagnostic and therapeutic for these patients.

A

X = orchiectomy (radical removal of entire testicle via inguinal excision)

18
Q

Seminoma: which lab markers are elevated? Star the one that rises to greatest extent.

A
  1. LDH*
  2. HCG

(don’t make AFP)

19
Q

Non-seminoma: which lab markers are elevated? Star the one that rises to greatest extent.

A
  1. LDH
  2. HCG
  3. AFP

Can be any combo, with varying amounts (depending on specific type of carcinoma)

20
Q

Embryonal carcinoma is a (seminoma/nonseminoma) and mainly makes which lab marker?

A

Non-seminoma

HCG (histo looks like that of embryo)

21
Q

Yolk sac carcinoma is a (seminoma/nonseminoma) and mainly makes which lab marker?

A

Non-seminoma

AFP (histo looks like that of yolk sac)

22
Q

Choriocarcinoma is a (seminoma/nonseminoma) and mainly makes which lab marker?

A

Non-seminoma

HCG (histo looks like that of placenta)

23
Q

T/F: Teratoma is a seminoma and responds best to chemo/radiation dual therapy.

A

False - it’s a non-seminoma that does NOT respond to chemo/radiation (requires surgical resection)

24
Q

(X) non-seminoma raises LDH, but not HCG or AFP.

A

X = teratoma

25
Q

Testicular cancer: what does stage 1S mean?

A

Imaging normal, but tumor markers elevated after orchiectomy

26
Q

The worst category of stratification for testicular cancer is (seminoma/non-seminoma) in Stage (X) and (Y) risk stratification group. What’s the cure rate?

A

Non-seminoma
X = III
Y = poor risk

74%

27
Q

T/F: In general, loss of one testicle does not negatively impact fertility

A

True - may actually improve function of contralateral testicle

28
Q

Retroperitoneal Lymph Node Dissection (RPLND) is a procedure only done in (X) testicular cancer patients. There is (rare) risk of which complication?

A

X = non-seminoma

Retrograde ejaculation

29
Q

Testicular cancer: which tumors get radiation?

A

Only seminomas (exquisitely sensitive to radiation)

30
Q

Multidrug chemo regimen for testicular cancer includes which drugs?

A

BEP or EP

  1. Bleomycin
  2. Etoposide
  3. cisPlatin
31
Q

Prostate zone where cancers most commonly arise.

A

Peripheral (posterior)

32
Q

Prostate zone where BPH most commonly arises.

A

Transitional zone

33
Q

Prostate cancer: neoplastic tissue has (X) texture

A

X = gritty

34
Q

List the two general forms of prostate adenocarcinoma:

A
  1. Lethal form (with local spread and metastasis)

2. “Incidental” latent form

35
Q

Gleason Grading System: It is (X) characteristics that forms the basis for grading, to assess the prognosis of (Y) cancer.

A 
X = degree of gland formation
Y = prostate adenocarcinoma

Oncology (10 decks)

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