Cancer

Question 1

scrotal violation for testicular CA with residual tumor marker

Answer 1

systemic chemo

bhcg: 1-3
afp: 5-7
ldh: 4

Question 2

rhabdomyosarcoma (paratesticular)

Answer 2

10 yo +: ipsilateral RPLND prior to xrt or chemo if nodes negative (if positive + xrt and intensified chemo)
all patients receive chemo for paratesticular rhabdo

Question 3

2nd most common prepubertal testis tumor…

Answer 3

yolk sac

if scrotal orchiectomy then go back and excise spermatic cord to internal ring

Question 4

chemo regimen for Wilms stage 3

Answer 4

In Wilms’ tumor, any tumor spillage, even if contained, automatically increases the tumor stage to at least stage 3. If doxorubicin is added to the standard chemotherapy, it allows reduction in the XRT exposure, limiting the added morbidity. With favorable histology, the standard chemotherapy of dactinomycin and vincristine (with the addition of doxorubicin) and XRT to the surgical bed is the recommended therapy.

Question 5

pure seminoma never secretes..

Answer 5

afp

Question 6

Risk of gonadoblastoma for turners (45xo but with Y)

Answer 6

12%; gonadoblastoma is in-situ tumor HOWEVER half specimens will have dysgerminoma or another germ cell tumor
if + dysgerminoma must survey with ct and tumor markers