14.3 Testicular Tumors Flashcards
Testicular tumors arise from what 2 tissues
germ cell
sex cord-stroma
how do Testicular tumors differ in presentation from hydrocele
can’t be transilluminated
What are most Testicular tumors not biopsied? (2)
risk of seeding the scrotum
>95% are malignant
what is tx for Testicular tumors
removal via radical orchiectomy
what is MC type of testicular tumorq
germ cell (>95%)
what age range do germ cell tumors usually occur
15-40
2 risk factors for germ cell tumors
cryptochordsim
Klinfelters
2 classifications of germ cell tumors and which is MC
seminoma - MC (55%)
nonseminomas (45%)
Seminomas: respnse to radiation, metastasize early or late, px?
excellent response to radiation
metastasize late
excellent px
Nonseminomas: respnse to radiation, metastasize early or late, px?
variable response to radiation
metastasize early
px?
3 chcs of seminoma on histo
large cell
clear cytoplasm
central nuclei
3 chc of seminoma tumor (HY)
homogenous mass
no hemorrhage
no necrosis
seminoma resembles what in ovary
dysgerminoma
rare seminoma may produce what
B-hCG
What do the cells in a embryonal carcinoma look like (2)
immature primitive
what might an embryonal carcinoma produce structurally
glands
why is embryonal carcinoma so aggresive and how does it spread
spreads hemtogenously and is aggressive because the embryonal cells are programmed to spread
What effect does CXT (chemothx) have on embryonal carcinoma (HY)
it cuases differentiation into teratoma or another type of germ cell tumopr
What two markers does embryonal carcinoma release
AFP, B-hCG (alpha fetoprotein)
what is MC testicular tumor in kids
yolk-sac (endodermal sinus tumor)
What marker is elevated in yolk-sac tumor
AFP
What is chc histo finding in yolk-sac tumor
Schiller-Duvall bodies (glomeruloid structure)
choriocarcinoma is malignant tumor of what 2 cells
syncytiotrophoblasts
cytotrophoblasts
how does choriocarcinoma spread
via blood
what is elevated in choriocarcinoma
B-hCG
What other condition may be seen in choriocarcinoma and why (HY)
hyperthyroidism may be seen becuase the alpha-subunit of hCG resembles thyroid homos (LH, FSH, TSH)
Benign or malignant: teratoma in females, in males (HY)
in males = malignant
in females = benign
what 2 markers may be increased in teratoma
B-hCG
AFP
in mixed germ cell tumors which tumor decides px?
the worst px
what are the two cells involved in sex-cord stromal tumors in males
sertoli
leydig
What is clinical presetation of Sertoli cell tumor
clinically silent
which cell forms the tubules and which is in interstitium- sertoli and leydig
sertoli = tubules Leydig = interstitium
what homo does leydig cell tumor produce
androgen
CHC hallmark of Leydig cell tumor on histo (HY)
Reinke Crystals
2 sequlae of leydg cell tumor
gynecomastia
precocious puberty
Germ cell tumor is MC cz of mass 15-40. What is MC testicular mass in >60 males? uni- or bilateral presentation?
lymphoma - often bilateral
What lymphoma type is usually seen in testicular masses
diffuse B-cell type
