B8-051 Testis Cancer Flashcards
why are testicular masses never biopsied?
high risk of seeding
testicular cancer spreads most commonly to the […] lymph nodes
lumbar (para-aortic)
(retroperitoneal)
most common symptoms of malignant testicular cancer
lymphatic
lung
malignant testicular masses are commonly [tender/non-tender]
non-tender
AFP is elevated in [2]
yolk sac tumors
teratomas
(can be falsely elevated due to hepatic dysfunction)
risk factors for germ cell tumors of testes [2]
cryptorchidism
klinefelters
b-hCG is elevated in [2]
seminomas
choriocarcinomas
(false elevations: tumor lysis, hypogonadism, marijuana, heterophile antibodies)
often used as a marker of burden of disease
LDH
isochromosome […] is frequently seen with testicular GCTs
12p
(karyotype or FISH)
can help determine if primary tumor is GCT or unknown
isochromosome 12p
GCTs are often removed via
radial orchiectomy
(regardless of staging)
most common GCT
excellent prognosis, highly sensitive to chemo/radiation
seminomas
may produce b-hCG but never AFP
pure seminoma
(if AFP+ its mixed)
large cells in lobules with watery cytoplasm and “fried egg” appearance on histo
seminoma
rarely “pure”, nearly always mixed
worse prognosis of non-seminomas
embryonal carcinoma
most common testicular cancer in children under 3
yolk sac tumor
significant elevation of AFP
yolk sac tumor
very high levels of b-HCG
choriocarcinoma
consists of cytotrophoblast and syncitiotrophoblasts
choriocarcinoma
GCT least responsive to radiation/chemo
teratoma
somatic tissue from different germinal layers
teratoma
seminomas can only be classified as: [2]
good, intermediate
(non-seminomas can be good, intermediate, poor)
presence of non-pulmonary visceral disease makes a patient […] risk
poor
most common chemo regimen used for testis cancer
BCP: bleomycin, etoposide, cisplatin
adverse effect of bleomycin
pulmonary fibrosis
(smoking hx, advanced age increases risk)
adverse effect of cisplatin
renal toxicity
most common cause of death in GCT survivors
secondary malignancy
characterized by an enlarging tumor with normalization of tumor markers
growing teratoma syndrome
resistant to chemo/radiation
teratomas
only curative modality for teratomas
surgical resection
any testicular mass is indication for […]
inguinal orchiectomy
if AFP is elevated, patient has [seminoma/non-seminoma]
non-seminoma
best imaging modality for testicular mass
US
(CT is used for staging)
