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Withrow > Chapter 28 - Tumors of the Male Reproductive System > Flashcards

Chapter 28 - Tumors of the Male Reproductive System Flashcards

1
Q

What is the most common location for tumors in the male reproductive system? What percentage of reproductive tumors do they comprise? Overall prevalence?

A

Testicles
90%
7% prevalence

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2
Q

What are the three most common testicular tumors and from what testicular subsets do they arise?

A

Sertoli cell tumor - sustentacular cells at seminiferous

Interstitial cell tumor - interstitial cells of Leydig between seminiferous tubules

Seminoma - spermatic germinal epithelium of seminiferous tubules

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3
Q

For which tumor is a cryptorchid testicle a risk factor?

Is there a difference between inguinal and abdominal cryptorchidism?

Which testicle is most commonly associated with cryptorchidism?

A

Sertoli cell tumors and seminomas

Crytporchidism is a risk factor overall, risk is higher with inguinal vs abdominal

Right testicle

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4
Q

Up to what percentage of dogs with testicular tumors have more than one type of testicular tumor?

A

4-20%

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5
Q

With what frequency do the different types of testicular tumors occur in dogs within the USA?

A

Equal frequency

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6
Q

In Norway, what breeds are at increased risk for developing testicular tumors? Which ones?

A

Shelties and Collies have a 5x increased
Shelties - majority (80%) are Sertoli
Collies - majority (70%) mixed Sertoli/seminoma
Norweigan elkhounds - 2x increased risk of seminoma

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7
Q

What hormones are produced by the different testicular tumors?

A

Sertoli - 50% produce estrogen and signs of feminization; 17% if scrotal

Interstitial - rarely testosterone and estrogen

Seminoma - rarely estrogen

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8
Q

What tumor is most likely to cause feminization signs?

How can estrogen be measured?

What are the clinical signs?

A

Sertoli (>50% if cryptorchid and 15% if scrotal)

Estraidol 17-B - usually higher when compared to normal dogs; not all dogs have elevated estraidol

Testosterone/estraidol ratio - usually lower; feminization signs occur secondary to disruptions in this ratio, may be a better

CS: bilateral symmetric alopecia, cutaneous hyperpigmentation, thinning of skin, galactorrhea, gynecomastia, atrophy of prepuce, atrophy of contralateral testicle, squamous prostatic metaplasia, bone marrow suppression

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9
Q

What is the metastatic rate of the different types of testicular tumors?

A

Sertoli - <15%
Interstitial - rare
Seminoma - <15%

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10
Q

What is the gross appearance of the different testicular tumors?

A

Sertoli - firm, lobulated, white or grey, greasy

Seminoma - homogeneous, soft, occasionally lobulated, ivory

Interstitial - soft, expansive, yellow to orange, often contain cysts with serous or serosanguinous fluid

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11
Q

Which testicular tumor can sometimes be associated with perianal gland hyperplasia?

A

Interstitial cell tumor

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12
Q

What are early vs late effects of estrogen in BM?

A

Transient increase in granulopoiesis with peripheral neutrophilia followed by progressive neutropenia, thrombocytopenia, and nonregenerative anemia, resulting in aplastic anemia and pancytopenia

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13
Q

What % of dogs with a testicular tumor have a contralateral testicular tumor or a primary tumor elsewhere?

A

50%

Therefore, COMPLETE STAGING is recommended

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14
Q

What is the treatment of choice for testicular tumors?

A

Bilateral orichectomy and scrotal abalation

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15
Q

After castration in dogs with Sertoli cell tumor, when do signs fo feminization resolve?

Prognosis if bone marrow hypoplasia or aplastic anemia present?

A

1 to 3 months after, unless metastasis is present

BM hypoplasia - guarded
Aplastic anemia - poor

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16
Q

How common are feline testicular tumors?

A

Rare; Sertoli, seminoma, interstitial cell tumor, and teratoma reported

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17
Q

What is the prevalence of prostatic tumors in dogs?

A

<1%

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18
Q

What is the most common prostatic tumor found in intact dogs?

A

Prostatic adenocarcinoma - usually urothelial or ductular in origin, rather than acinar, since they are androgen-independent

19
Q

Where does TCC arise from within the prostate?

A

Prostatic ducts

20
Q

What is an identified risk factors for prostatic carcinoma development in dogs?

A

Castration; OR 2.3:4.3

21
Q

What % of dogs with prostatic carcinoma have metastasis at the time of diagnosis and at the time of death?

Which px may be at increased risk for metastasis?

A

40% at diagnosis; SLLN most commonly
80% at death

Younger dogs

22
Q

What % of canine prostatic carcinoma develops metastatic disease to bone? Most common site?

A

22 to 42%

Lumbar vertebrae

23
Q

What % of dogs with prostatic carcinoma have COX-2 expression?

A

75-88% express COX-2 (vs 0% normal prostate tissue)

24
Q

Predilection for bone in prostatic carcinoma may be mediated by what 3 things?

A

TGF-B, PTH-rP, endothelin

25
Q

Mets from prostatic carcinoma to bone have what action on bone? Osteoproductive or osteolytic?

A

More commonly osteoproductive, but can also be osteolytic

Skeletal metastasis most commonly OSTEOBLASTIC in nature

26
Q

MST of dogs with prostatic carcinoma treated with NSAIDs vs no treatment?

A

NSAID MST 7m (6.9m); another 2018 study said 1.7m

<1m (0.7m or 21d)

27
Q

What % of dogs with prostatic carcinoma have a BRAF mutation?

A

85%

28
Q

What is the benefit of systemic chemo for prostatic carcinomas?

A

Unclear

29
Q

What tumors usually affect the soft tissues of the penis, prepuce, and scrotum in dogs? What are the most common neoplasm of the canine penis?

A

TVT, SCC (most common ones), sebaceous gland adenoma, mesothelioma, papilloma, lymphoma, plasma cell tumor, mast cell tumor, hemangioma, melanoma, fibrosarcomaTVT and SCC

30
Q

What bone tumors can arise from the os penis?

A

Ossifying fibroma, benign mesenchymoma, multilobular osteochondrosarcoma, osteosarcoma

OSA behaves similar to axial OSA

31
Q

What is the tx of choice for penile tumors?

A

Perineal urethrostomy and penile amputation

32
Q

Tx for TVT?

A

Chemotherapy with vinc, not sx, also responsive to RT

33
Q

Mineralization in the canine prostate can be due to what?

A

In intact dogs - prostatitis, BPH, cysts

In neutered dogs - 100% PPV for neoplasia

34
Q

What should the size of the prostate be in a neutered dog?

A

Small; a normal sized prostate in a neutered dog is abnormal

35
Q

What % of dogs with prostatic carcinoma have a concurrent UTI?

A

33-36%

36
Q

Prostatectomy should be considered in which dogs?

A

Dogs with early stage dz and no capsular involvement

37
Q

What % of dogs undergoing total prostatectomy develop major complications, transient incontinence, and permanent incontinence?

A

Major complications - 16%: dehiscence, uroabdomen, prepubic herniation

60% transient - resolved within 4 weeks

35% permanent incontinence

38
Q

In the VSSO study where dogs were treated with prostatectomy, did the addition of chemotherapy prolong ST?

A

No

39
Q

What is the DFI and MST in dogs with prostatic carcinoma when treated with prostatectomy, NSAIDs, and chemo?

Negative PI in the VSSO study?

A

DFI 2.7m
MST 7.7m
1-yr SR 32% and 2-yr SR 12%
Histologic extracapsular extension MST 4.6m

40
Q

Overall clinical response rate and MST of dogs with TCC and prostate involvement when treated with chemo and an NSAID?

A

Clinical response 33%

MST 3.5m

41
Q

Negative PI in dogs with prostatic carcinoma when treated with chemo + NSAID?

A

Intact male status - shorter MST
Presence of CS - shorter MST
Metastasis to sites other than lungs - shorter MST
Tx with NSAIDs alone

42
Q

Survival time of dogs with prostatic lymphoma? How does it usually present? LN involvement and multicentric dz? Most common phenotype?

A

Mean ST 2m; 2 dogs tx with chemo survived for 1 and 10m

56% had LN involvement and all appeared to have multicentric intra-abdominal dz

High grade T cell lymphoma

Absence of mineralization on AUS

43
Q

Prostatic tumors in cats? Most common one? Survival time?

A

Rare
Adenocarcinoma
Most die within 3m

Withrow (13 decks)

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