Disease of Testis, Prostate, + PENIS Flashcards
Cryptorchidism
- Unilateral or bilateral more common?
- Cause?
- When can atrophy be seen?
- risk of malignancy?
Unilateral (75%)
Majority are idiopathic
Atrophy early as age 2
- contralateral testis may also regress
5x increased risk of malignancy
Most common cause of testicular atrophy that can affect fertility
Atherosclerosis
Causes of testicular atrophy
- Atherosclerosis
- Cryptorchidism
- Inflammation
- Malnutrition
- Hypopituitarism
- Hormone therapy (prostate cancer)
- Klinefelter’s syndrome
Klinefelter’s syndrome FSH, LH and T levels
Elevated FSH/LH
Decreased T
*leydig cell hyperplasia
Varicocele
an abnormal enlargement of the pampiniform venous plexus in the scrotum. This plexus of veins drains the testicles. –>
Tortuosity of veins –>
Infarcts arteriole flow
Usually unilateral
- left side 90%
Associated with infertility if bilateral
Inflammatory disease of Testis and epididymis
- Nonspecific epididymitis & orchitis
- extension of urinary tract
- urinary tract malformation
- Chlamydia, gonorr
- enterobacteria - Mumps orchitis
- Tuberculous orchitis
- Syphilis
- Granulomatous (autoimmune) orchitis
Mumps orchitis
- age
- how long after infxn?
Pubertal or adult males
Presents 1 week after parotid involvement
- ache, not sharp
Unilateral (70%)
- infertility uncommon
Tuberculus orchitis
Epididymus affected first –> testis
Usually part of systemic disease
Caseating granulomas
Syphilis
Testis affected first –> Epididymis
Congenital or acquired
Testicular tumors
- most common type?
- age?
- pain?
Vast majority are germ cells tumors
- Seminoma
- Spermatocytic seminoma
- Embryonal
- Yolk sac
- Choriocarcinoma
- Teratoma
- Mixed
*diff names comes from diff levls of germ cells of pluripotential cells
Younger men (15-30)
Painless testicular enlargement
Seminoma
Most common Germ cell tumor (50%)
- 4th decade (30-40)
- radiosensitive and chemosensitive
- good prognosis
- serum markers often negative
Spermatocytic seminoma
1-2% of Germ cell tumor
- developing spermatids
- most benign GCT
Older age (>50)
Good prognosis
Serum marker negative
Embryonal carcinoma
- Mixed Embryonal carcinoma is common type
- Recurrance is common
- Most Immature stage
Third decade (20-30) Markers: PLAP, placental lactogen, hCG
Chemosensitive
Teratoma
40% of testis tumors in infants
Most mature stage
Malignant transformation
- slow to progress, but may undergo malignant change
CHEMORESISTENT
Yolk sac tumor
Pure common in children (80% of testicular tumors)
Part of mixed tumor in adults (40-50%)
Prognosis is relatively good
Produces alpha-fetoprotein (AFP)
Choriocarcinoma
Most Aggressive GCT - often met
Chemosensitive, but worse prognosis
Produces hCG
-PLACENTAL like
Testis cancer staging
Stage I - confined to testis
Stage II - retroperitoneal nodes or below diaphragm
Stage III - Outside retroperitoneal nodes or ABOVE diaphragm
Most common testicular tumor in men >60
Lymphoma
Not Germ cell tumor
Most common penile malignanciues
Epithelial (95%)
- Squamous cell carcinoma (95% of that)
Mesenchymal (5%)
Limited lesions (havent invaded yet) of penis
- Carcinoma in situ
- Verrucous carcinoma
- wart appearance, local destruction to penis w/o metastasis
Penile squamous carcinoma
- precursor
- age
- population
precursor lesion: carcinoma in situ
60-80 years
“chimney sweeps disease”
AA 2: White 1
Penile SCC staging by location
Stage I: confined to glans prepuce
Stage II: penile shaft
Stage III: operable inguinal node mets
Stage IV: distant mets
