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14 Male Genital > 14.3 Testicular Tumors > Flashcards

14.3 Testicular Tumors Flashcards

1
Q

Embryonal carcinoma, testicle

-prognosis

A
  • Aggressive with hematogeous spread
  • chemo can result in differentation into another type of germ cell tumor!
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1
Q

Reinke crystals

A

histologic finding in Leydig cell tumors

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2
Q

Choriocarcinoma, testicle

-made of what cells? (2)

A

-tumor of syncytiotrophoblasts (produce hCG) and cytotrophoblasts

(placenta like tissue, but villi are absent)

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3
Q

Seminoma

  • histology presentation
  • gross presentation
A
  1. large cells with clear cytoplasm and central nuclei (resemble spermatogonia)
  2. homogenous mass with no hemmorhage or necrosis
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3
Q

Testicular tumors: think what type based on age:

  • young adult
  • elderly
A

15-40 Germ cell tumor

>60 Lymphoma

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5
Q

Seminoma vs non-seminoma

  • %
  • general differences
A

seminoma (55%)

-respond well to radiotherapy, metastasize late, good prognosis

non-seminoma (45%)

-variable response to tx, metastasize early

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6
Q

Germ cell tumors, testicle

-risk factors include what congenital problems (2)

A
  1. cryptorchidism
  2. Klinefelter (XXY)
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6
Q

Sertoli cell tumor

-presentation

A
  • usu clinically silent
  • comprised of tubules
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7
Q

Testicular tumors, basics:

  • arise from what cell types? (2)
  • clinical presentation
  • why not biopsy? (2)
A
  1. germ cells
  2. sex-cord stroma

(no surface epithelium as in females)

  • presents as testicular mass that can’t be transilluminated
  • do NOT biopsy:
    1. risk of seeding scrotum
    2. most tumors are malignant germ cell tumors, so remove anyway
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8
Q

Seminoma

-prognosis?

A

Excellent. responds well to radiotherapy

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8
Q

What is most common testicular tumor in children?

A

Yolk sac tumor

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8
Q

Secretion of AFP and B-hCG:

  1. embryonal carcinoma
  2. yolk sac
  3. CC
  4. teratoma
  5. Seminoma
A
  1. AFP and B-hCG may be increased
  2. AFP characteristically elevated
  3. B-hCG characteristically elevated (gynecomastia, hyperthyroidism)
  4. AFP, B-hCG may be increased
  5. rarely produce B-hCG
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10
Q

You see cross section of testicular tumor. It has homogenous color with non hemorrhage or necrosis.

Think what?

A

Seminoma

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11
Q

Teratoma, testicular

  • made of what
  • how is it different from female teratoma
  • what may be increased in blood
A
  • made of mature fetal tissue, derived from 2-3 embryonic layers
  • Malignant in males, Benign in females
  • AFP and B-hCG may be increased in blood
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13
Q

Germ cell tumors, testicle:

-divided into what tumors

A
  • seminoma
  • non-seminoma:
    1. Embryonal
    2. Yolk sac
    3. Choriocarcinoma
    4. teratoma
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14
Q

Choriocarcinoma, testicle

-what unique complications and why? (2)

A
  1. hyperthyroidism (TSH)
  2. gynecomastia (LH, FSH)
    - B-hCG is elevated (secreted by syncytiotrophoblasts), and its alpha-subunit is similar to LH, FSH, TSH.
15
Q

What is the most common testicular tumor?

A

Seminoma

16
Q

B-hCG

  • secreted by what
  • elevated levels can cause what side effects?
A

secreted by syncytiotrophoblasts of placenta (and placenta like tissue)

  • characteristically elevated in choriocarcinoma
  • b/c its alpha subunit is similar to LH, FSH, TSH:

LH, FSH: gynecomastia

TSH: hyperthyroidism

17
Q

Male pt presents with testicular mass, gynecomastia, and hyperthyroidism

-think what

A

Choriocarcinoma

-increased hCG results in LH, FSH, TSH activation

18
Q

Leydig cell tumor

  • presentation:
    1. children
    2. adults
  • Characteristic histology finding
A
  • produces androgen, so it causes:
    1. precocious pubery in children
    2. gynecomastia in adults
  • Reinke crystals in histology
19
Q

Sex-cord stromal tumors, testicle

  • benign/malignant
  • divided into what
A

Usu benign

  1. Leydig cell
  2. Sertoli cell
21
Q

Testicular tumor:

-on histology, you see glomerulus like structures

What tumor?

A

Yolk sac tumor

22
Q

Yolk sac tumor, testicle

  • histology
  • what is elevated in blood
A
  • Schiller-Duval bodies (glomerulus like structures_
  • AFP characteristically elevated
24
Q

You see cross section of testicular tumor. It has central hemorrhagic mass with necrosis

Think what?

A

-Embryonal carcinoma

(a non-seminoma germ cell tumor)

25
Q

Male pt presents with massive metastatic cancer throughout body, including small tumor in testicle. Think what?

A

Think choriocarcinoma

  • classic: small primary tumor, massive metastasis
  • spreads early by blood
26
Q

Don’t use chemotherapy on which testicular tumor? why?

A

Embryonal carcinoma

-chemo can result in differentation into another type of germ cell tumor (eg teratoma) b/c embryonal cells are immature, primitive cells

27
Q

Choriocarcinoma, testicle

-classic presentation

A
  • tiny primary tumor, but massive metastasis
  • b/c CC spreads early in blood! (these cells are programmed to invade blood)
28
Q

Testicular tumors (8)

  • divided into what categories
  • name them all
A

Germ Cell:

  1. seminoma
    - non seminomas:
  2. Embryonal
  3. Yolk sac (endodermal sinus)
  4. Choriocarcinoma
  5. Teratoma

Sex-cord stromal tumors:

  1. Leydig cell
  2. Sertoli cell

Other:

  1. Lymphoma
29
Q

Lymphoma, testicle

  • presentation, population
  • usu what type of lymphoma?
A
  • most common cause of testicular mass in males >60
  • often bilateral
  • usu diffuse large B-cell type
30
Q

Embryonal carcinoma, testicle

  • composed of what
  • gross appearance
  • look for what elevated in blood?
A
  • composed of immature, primitive cells that may produce glands (may secrete AFP or B-hCG)
  • central hemorrhage and necrosis
  • AFP and B-hCG often elevated. (not specific among testicular tumors)

14 Male Genital (4 decks)

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