GUT: Penile Disease and Disorders of the Testes Flashcards
Most common type of penile malignant tumour? Other more uncommon types?
SCC is most common
Others: Malignant melanoma, spindle cell carcinoma, adenosquamous carcinoma
Risk factors of penile cancer
Poor hygiene Uncircumcised Phimosis HPV Smoking?
PRE NEOPLASTIC CONDITIONS
- –Bowenoid papulosis
- –Erythroplasia de queyrat
- -Bowens disease
___ cells produce testosterone
Leydig
What organism is the most common cause of epidiymo-orchitis?
E coli UTI
Which age group is affected by testicular cancer?
Young males, usually 18-55
Good prognosis
Most common type of malignant tumour of testes?
Germ cell tumour (90%)
Other are:
Sex cord stromal tumours in 5% (Leydig and Sertoli)
Lymphoma/leukamia
What are the 3 types of germ cell tumours?
Seminoma (50%)
Teratoma (15%) (non seminomatous GCT)
Mixed Germ cell tumour (33%)
Most common testicular tumour?
Seminoma, good prognosis and radiosensitive
Age group affected by seminomas?
40-50
Gross appearance: Fleshy, pale tumour
Seminoma
Histology of seminoma: Sheets of large cells, with _____ stroma which sometimes contains granulomas in association.
Intratubular ____ cell neoplasia in tubules with no spermatogenesis
Lymphoid
Germ
Name the four groups of Teratoma classification? (MTD, MTI, MTU, MTT)
MTD: Differentiated (mature, might contain skin, teeth, hair, respiratory tissue)
MTI: Intermediate (Primitive epithelium)
MTU: Undifferentiated (Purely anaplastic teratoma with no intermediate elements)
MTT: Trophoblastic (Rare)
Non-seminomatous GCTs (teratomas): embyronal carcinoma
Common, MTU undifferentiated
Non-seminomatous GCTs (teratomas) types (5)
Malignant teratoma Embryonal carcinoma Yolk sac tumour Choriocarcinoma Mixed forms (polyembryoma)
Which teratoma is asscoiated with Shiller-Dival body on histology?
Yolk sac tumour
Central vessel with a rim of epithelial cells
Which magignant teratoma is associated with haemorrhage?
Choriocarcinoma
Which markers are raised in seminomas?
LDH (lactate dehydrogenase)
Which markers are raised in teratomas eg chriocarcinomas, and mixed germ cell tumours?
AFP
HCG
Where does testicular cancer metastasise to?
Lymph nodes
Lungs
Brain
Treatment of testicular cancer?
Radical orchidectomy through the inguinal canal
Radiotherapy for seminomas
Chemotherapy for teratomas and seminomas
MRC criteria for additional chemotherapy in testicular cancer (1 point for each)
(Adverse prognostic factors)
Presence of embryonal carcinoma
Absence of yolk sac tumour
Lymphatic invasion
Vascular invasion
