Gonadal Neoplasms Flashcards
T/F: Few gonadal malignancies are germ cell tumors in pediatrics.
False. Almost all gonadal neoplasms are germ cell tumors.
What percentage of germ cell tumors in children are extragonadal?
Approximately 2/3
If a testicular mass is palpated, what is the suggested approach to diagnosis and management?
First, order an ultrasound to determine if the mass is solid or not. If it is solid, proceed straight to orchiectomy. Biopsy should never be performed due to the risk of seeding the biopsy tract.
What are the two histological subtypes of teratoma?
Mature (composed of well-differentiated adult-type tissues) and immature (composed of embryonic tissues).
Where are most teratomas located?
Teratomas most commonly occur in the sacrococcyx, ovaries, testes, and anterior mediastinum.
Which patient with a teratoma is particularly predisposed to undergo malignant transformation (i.e. what age and what location)?
In an infant with sacrococcygeal teratoma, the risk of malignant transformation increases to 50% once the infant is older than 2 months of age.
When would chemotherapy be indicated in a child diagnosed with a teratoma?
Chemotherapy is only indicated if malignant elements are discovered.
What is a germinoma?
Germinoma is a malignant germ cell tumor that can occur in the ovary (dysgerminoma), the testes (seminoma), and extragonadally.
Do germinomas produce AFP or β-hCG?
No, even though they are malignant, they are often tumor marker negative.
What is embryonal carcinoma?
It is made up of primative malignant cells and occurs most commonly in the testes of adolescents.
What is the most common malignant childhood germ cell tumor?
Endodermal sinus (yolk sac) tumor
What tissue is found in choriocarcinoma?
Choriocarcinoma is a malignant tumor characterized by the finding of syncytiotrophoblast tissue (placental tissue).
With which karyotypes do gonadoblastomas occur?
46 XY or 46 XY/XO. 80% have female phenotype.
Which germ cell tumors have elevated AFP and/or β-hCG tumor markers?
Embryonal carcinomas produce β-hCG but not AFP. Yolk sac tumors produce AFP but not β-hCG. Choriocarcinomas produce β-hCG but not AFP.
