B8-051 Testis Cancer

Question 1

why are testicular masses never biopsied?

Answer 1

high risk of seeding

Question 2

testicular cancer spreads most commonly to the […] lymph nodes

Answer 2

lumbar (para-aortic)

(retroperitoneal)

Question 3

most common symptoms of malignant testicular cancer

Answer 3

lymphatic
lung

Question 4

malignant testicular masses are commonly [tender/non-tender]

Answer 4

non-tender

Question 5

AFP is elevated in [2]

Answer 5

yolk sac tumors
teratomas

(can be falsely elevated due to hepatic dysfunction)

Question 6

risk factors for germ cell tumors of testes [2]

Answer 6

cryptorchidism
klinefelters

Question 7

b-hCG is elevated in [2]

Answer 7

seminomas
choriocarcinomas

(false elevations: tumor lysis, hypogonadism, marijuana, heterophile antibodies)

Question 8

often used as a marker of burden of disease

Answer 8

LDH

Question 9

isochromosome […] is frequently seen with testicular GCTs

Answer 9

12p

(karyotype or FISH)

Question 10

can help determine if primary tumor is GCT or unknown

Answer 10

isochromosome 12p

Question 11

GCTs are often removed via

Answer 11

radial orchiectomy

(regardless of staging)

Question 12

most common GCT

excellent prognosis, highly sensitive to chemo/radiation

Answer 12

seminomas

Question 13

may produce b-hCG but never AFP

Answer 13

pure seminoma

(if AFP+ its mixed)

Question 14

large cells in lobules with watery cytoplasm and “fried egg” appearance on histo

Answer 14

seminoma

Question 15

rarely “pure”, nearly always mixed
worse prognosis of non-seminomas

Answer 15

embryonal carcinoma

Question 16

most common testicular cancer in children under 3

Answer 16

yolk sac tumor

Question 17

significant elevation of AFP

Answer 17

yolk sac tumor

Question 18

very high levels of b-HCG

Answer 18

choriocarcinoma

Question 19

consists of cytotrophoblast and syncitiotrophoblasts

Answer 19

choriocarcinoma

Question 20

GCT least responsive to radiation/chemo

Answer 20

teratoma

Question 21

somatic tissue from different germinal layers

Answer 21

teratoma

Question 22

seminomas can only be classified as: [2]

Answer 22

good, intermediate

(non-seminomas can be good, intermediate, poor)

Question 23

presence of non-pulmonary visceral disease makes a patient […] risk

Answer 23

poor

Question 24

most common chemo regimen used for testis cancer

Answer 24

BCP: bleomycin, etoposide, cisplatin

Question 25

adverse effect of bleomycin

Answer 25

pulmonary fibrosis (smoking hx, advanced age increases risk)

Question 26

adverse effect of cisplatin

Answer 26

renal toxicity

Question 27

most common cause of death in GCT survivors

Answer 27

secondary malignancy

Question 28

characterized by an enlarging tumor with normalization of tumor markers

Answer 28

growing teratoma syndrome

Question 29

resistant to chemo/radiation

Answer 29

teratomas

Question 30

only curative modality for teratomas

Answer 30

surgical resection

Question 31

any testicular mass is indication for [...]

Answer 31

inguinal orchiectomy

Question 32

if AFP is elevated, patient has [seminoma/non-seminoma]

Answer 32

non-seminoma

Question 33

best imaging modality for testicular mass

Answer 33

US (CT is used for staging)