cancer Flashcards
rf testicular cancer
Age <45
Caucasian
Previous testicular cancer
Cryptorchidism
HIV (seminomos)
downs - crypto is more common as well as acquired undescended
synchronous and metochronous
(synchronous – both testes at same time or metachronous – operated before on left testes and then occurs in right)
classifcation of testicular
GERM CELL OR NON GERM
GERM
-seminoma
-non seminoma (teratomas, yolk, choriocarcinoma )
testicular markers
hcg
AFP
Ldh-non specific but indicates metastisis
other book says SP1?
whcih marker is yolk sac
AFP
which marker is choriocarcinoma
hcg
ln to look out for in testicular
retroperitoneal
-paracaval
-precaval
-retrocaval
-preaortic
-interaorthocaval
fist ln to drain is the paraoartic ln
metatsits of testicular cancer
m 1 a - above diaphragm or in lung
m1 b - liver bone brain
t1 testicular
confined in testes and epididymis no invasion yet inot lymphatics /venous system
t3 testicular
spermatic cord
which other lN can be affected in testicular
pelvic and inguinal are affected secodnarlity to retroperitoneal
which cancer is radiosensitive
seminomas
which testicular cancers have good prognosis
seminomas
which testicular cancers have good prognosis
seminomas
complications of radical orchiectomy
Post-op haematoma and reduced fertility.( sperm banking before hand )
2 most common testicular tumours
seminoma and teratoma
2 most common testicular tumours
seminoma and teratoma
1st line diagnostic in TESTICULAR
ultrasound
- can tell you the nature (is it cystic or malignant )
1st line diagnostic in TESTICULAR
ultrasound
- can tell you the nature (is it cystic or malignant )
what marker could a teratoma have
raised alfa feto protein but less common than yolk sac
transtional carcinomam rf
smoking, occupational exposure to chemicals, chronic bladder irritation, arsenic, personal history of cancer in the urinary tract, and aristolochic acids.
if you already hav e bladder cancer
sympotms of transitionla
heamturia
sympotms of transitionla
heamturia
back pain
dysuriaa- freuqne or urgent urination
risk for bladder cancer
chronic irrtatin
chronic infection
arsenic in well water
occupational - amines
not voiding bladder for long times
PSAC
-phenylalanine
- smoking
- analine
-cyclophosphamide
GREATEST RF FOR RCC
SMOKING
HOW would you diagnose a varicolcels
scrotal ultrasound will show enlargement of veins
most common histological type of bladder cancer
transitional/urothelial
types of bladder cancer
urothelial
adenocarcinoma
sqaumous
small cell bladder cancer
Risk factors for Squamous cell carcinoma bladder
Schistosomiasis infection
Long term catheterisation (10+ years)
tx for advanced RCC
as you know chemo and radio therapy reistance
- monoclonal antibodies (immunotherapy)
-immune checkpoint inhibirots (immunotherpay also)
radical neprhectomy vs simple
how can we do this porecdure
radical : whole kidney, ln, surrounding tissue
simples: just kindey
open or laproscopic is increasingly being used
t4 testicular
infiltrates the scrotum
most common place for testicular cnacer to spread too
the lung and lymph nodes of chest
m1a tetsicular cancer
spread to the lung or non regional lN
m1b testiucalr cancer
it spreads to the other organs like brain, liver bone
how do we asses tumour markers in testicular cancer
before and after surgery, if it increases more than 5 days pst op sign of metastasis
what other part of the body must you always check in testicular cancer
breasts as some can cause gynecomastia
most common side for Testicular
RHS (as cryptochordims happens on this side more frequently
whats important about orchiectomy for TT
iNGUINAL INCISION NOT SCROTAL !!!!
SPREAD OF TT
The main mode of spread of TT is lymphogenic route, except choriocarcinoma which is
hematogenous.
types of penile cancer
most common isi squamous
penile cancer spread
inguinal , superficial and deep
spread of penile cancer
lymph like testicular
whats important to rememeber in penile cancer
always do INGUINAL LN
whats important to rememeber in penile cancer
always do INGUINAL LN
WHAT Happens in penile cancer if the inguinal ln are negative
you still dissect the inguinal , and you watch and wait to see if it spreads to the other lN ( you dont have to perform imaging
what lymph nodes does penile cnacer spread too in order
inguinal and pelvic
benign tumours of penis
condyloma acuminita - most common
pearly penile papules - just a cosmtetic issue
lichen scleroosis et atrophicus
bowen disease
cutaneous horn
surgery for penile cancer non invaisve
if non invasive -below T2 - penile conserving surgery
just do either circumcission if just on prepuce or do circumsion and wide local excison of the area e.g glans
invasive penile cancer tx
above t2
partial or toral penile amputation with or without immasculinisation (remove testes).
total- whole penis gone
urethra needs to be reconstructed to the perineum as now you have no penis
invasive penile cancer tx
above t2
partial or toral penile amputation with or without immasculinisation (remove testes).
total- whole penis gone
urethra needs to be reconstructed to the perineum as now you have no penis
bowenn disease
scc in situ - grows very slwoly which is good
neprhorblastoma orgin and wilms
mesoderm
heritdary RCC
Hereditary RCC show a tendency to be multiple and bilateral location, present at earlier age
of onset, bad prognosis
SYNROMES FOR KIDNEY CANCER
vhl
BIRT HOGG DUBE SYNDROME
which renal tumour is assoc with hypertension
oncocytoma
