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ABDOMEN 4 > 1.3 Malignant Scrotal Pathologies > Flashcards

1.3 Malignant Scrotal Pathologies Flashcards

1
Q

Malignant Testicular tumors often present with (7)

A 
painless
Scrotal enlargement 
Hardness of testicle
Unilateral
hypoechoic 
Increased vascularity
May have hydrocele?
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2
Q

Malignant Tumors most common cause of death in men between age ___ to ___

A

15-34

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3
Q

Malignant tumors arise from?

A

Germ cells

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4
Q

What are the 2 types of germ cell tumors (not L & S)

A

Seminomas and Nonsemionmatous tumors

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5
Q

WHAT IS THE MOST COMMON TYPE OF GERM CELL TUMOR?

A

SEMINOMAS

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6
Q

Seminomas often occur in men __ to __ years

A

30-40

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7
Q

What blood work is seen with Seminomas

Increase____ normal_____

A

BETA HCG ; AFP

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8
Q

What are the least aggressive malignant tumors with best prognosis?

A

seminomas

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9
Q

What is the sonographic appearance of a seminoma? (5)

A 
Solid
Homogenous
Hypoechoic
Scattered hyperechoic areas (like micro calcs)
pseudocapsule
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10
Q

What is the more aggresssive tumor than seminoma tumors?

A

non seminomatous germ cell tumors

NSGCT

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11
Q

non seminomatous germ cell tumors (NSGCT) cause _________ meaning they spread to other organs

A

Visceral Matastases

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12
Q

non seminomatous germ cell tumors (NSGCT) Include which tumors?

A 
Embryonal cell carcinoma
Yolk Sac tumor
Coriocarcinoma
Teratoma
Mixed germ cell tumors
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13
Q

What is the 2nd most common type of testicular cancer

remember: seminoma 1st- way more common

A

Embryonal Cell Carcinoma

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14
Q

Embryonal Cell Carcinoma tends to occur in men ___ to ___ years

A

25-35

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15
Q

The most aggressive testicular cancer is ?

A

Embryonal Cell Carcinoma

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16
Q

WHAT BLOOD WORK MAY OR MAY NOT BE ELEVATED IN THESE PATIENTS WITH EMBRYONAL CELL?

A

AFP

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17
Q

what is the most common infantile (< 2yrs) form of embryonal cell carcinoma?

A

yolk sac tumor

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18
Q

What blood work is always elevated with yolk sac tumor?

A

AFP

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19
Q

What is the sonographic appearance of embryonal cell carcinomas (3)

A

Hypoechoic
often mixed echogenicity
more poorly defined then seminoma

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20
Q

What is an uncommon agressive tumor affecting 20 - 30 years of age

A

Coriocarcinoma

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21
Q

Coriocarcinoma has high incidence of ______ involvement

A

pulmonary

may metastasize to lungs

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22
Q

WHAT BLOOD WORK IS ALWAYS ELEVATED IN Coriocarcinoma

A

SERUM BETA HCG

bc of this may cause gynecomastica/scrotal pain

23
Q

Coriocarcinoma sonographically

A

small, mixed echogenicity, irregular boarders

24
Q

Teratoma (rare) occur at low frequency and typically____ in children and ____ in adults

A

Benign; malignant

25
Q

WHAT BLOOD MAYBE ELEVATED IN Teratoma suggesting malignancy?

A

AFP &; BETA HCG

26
Q

Teratoma Sonographically

A

Cysitc and Solid components
May demonstrate, shadow or enhancement
well defined

27
Q

What is the most common Mixed Germ cell Tumor

A

Teratocarcinoma (teratoma mixed with Embryonal cell)

28
Q

What is the largest malignant tumor?

A

Mixed Germ cell Tumor

29
Q

Mixed Germ cell Tumor sonographically

A

Large
Heterogenous
Cystic areas and echogenic foci

30
Q

How do you differentiate testicular tumors

A

Biopsy

31
Q

What is a burned out tumor?

A

Echogenic or calcified scar in the testicle. Regression of a primary tumors (outgrows its blood supply and regresses)

32
Q

REVIEW QUESTIONS

A

…………..

33
Q

what is metastatic disease

A

Cancer originated else where (another primary site) and has spread to the testicular tissue

34
Q

What is the most common metastatic tumor of the testes ?

A

Lymphoma

35
Q

Lymphoma is most common in what age group?

A

> 50 years old

36
Q

What is the mot common TYPE of Lymphoma

A

Non-Hodgkin

37
Q

What is the most common presentation of Lymphoma

A

Painless
mass
DIFFUSE enlargement

38
Q

Metastatic Lymphoma sonographically (4)

A

Hypo
homogenous
DIFFUSE (entire teste enlarged) or focal mass
Hypervascular

39
Q

What is the SECOND most common metastatic tumor of the testes ?

A

Leukemia

40
Q

What is the most common NON-lymphamatous metastatic tumor of the testes ?

A

Prostate & lung

41
Q

Metastatic Spread possible routes (4)

A

Retrograde venous
Hematogenous (arterial supply)
Retrograde lymphatic system
or direct tumor invasion

42
Q

Post Vascectomy changes occur in ____ % patients

A

45

43
Q

Vasectomy changes include (5)

A 
Epididymal enlargement 
Heterogenous 
Cysts/ Spermatoceles
Sperm Granuloma (sperm escapes and is walled off)
Tubular Ectasia
44
Q

What is Tubular Ectasia

A

dilated tubules in epi or Rete testes
Various sized cystic lesions maybe mistaken for neoplasm
bilateral but asymmetrical
often has a spermatocele

45
Q

Tubular Ectasia will not demonstrate?

A

COLOR FLOW

unlike varicocele in testicles that will have flow

46
Q

Ultrasound after a Post Orchiectomy can be use to assess (4)

A

assess the scrotal space for

  1. Abscess
  2. Hematoma
  3. Recurrent neoplasms
  4. or for placement of Prosthesis
47
Q

MORE REVIEW

A
48
Q

MOST COMMON CAUSE OF PAINLESS SCROTAL SWELLING

A

Hydrocele (collection of fluid in bw layers of tunica vag)

49
Q

WHAT IS THE STRUCTURE THAT FORMS THE MEDIASTINUM?

A

TUNICA ALBUGINEA (supportive structure for RT)

50
Q

WHAT OTHER EPIDIDYMAL ABNORMALITY CAN TYPICAL OCCUR WITH TUBUALR ECTASIA?

A

Spermatocele

51
Q

WHAT IS THE MOST COMMON TYPE OF TESTICULAR TORSION?

A

Intravaginal (associated -bell clapper)

52
Q

MOST COMMON CAUSE OF ACUTE SCROTAL PAIN

A

Epididymitis

53
Q

WHAT IS THE ALTERNATIVE NAME FOR THE EPI HEAD

A

Globus major

ABDOMEN 4 (10 decks)

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