Lec 9-10 Male GU Flashcards
What should you look for in urine sample with RBCs to tell if it was a good specimen?
look for epithelial cells –> could mean contamination
How common is bladder cancer?
4th most common cancer in US in men
What are risk factors for bladder cancer?
- smoking = biggest factor
- radiation to pelvis
- narcotic use
- chemical exposure [aromatic amines, benzenes]
- schistosomiasis
- age > 40
- male
What is transitional cell carcinoma of the bladder?
most common tumor of urinary tract system
have painless hematuria [no casts]
What is squamous cell carcinoma of bladder?
- 1-2% of all bladder cancers
- chronic irritation of urinary bladder causes squamous metaplasia leading to dysplasia
- associated wtih schistosoma
What is adenocarcinoma of the bladder?
1-2% of all bladder cancers
aggressive
can be urachal
What is CIS in bladder?
carcinoma in situ in bladder = superficial high grade cancer; can invade
Why is bladder cancer so hard to treat?
can recur anywhere in ureters, bladder, renal pelvis = thought to be a field defect of the mucosa
What are principles of bladder cancer treatment?
superficial low grade –> survey
superficial high –> re-resect
- muscle invasive: cystectomy
What does it suggest if testicular cancer with HCG and AFP?
mixed germ cell tumor
What is median age at diagnosis testicular cancer?
33 yo
What are risk factors for testicular cacner?
- cryptorchidism [undescended testicle]
- family history
- HIV
What is most prevalent type of tersticular tumor?
seminoma = 33%
What are characteristics of anaplastic seminoma?
more aggressive than classic
What are characteristics of spermatocytic seminoma?
more common > 50 yo
less aggressive
What are characteristics of embryonal carcinoma?
malignant; hemorrhagic; painful
more aggressive = worse prognosis
often mixed with other tumor types
high ACG and normal AFP when pure; also high AFP when mixed
What are characteristics of teratoma?
mature teratoma in adult males can be malignant
resistant to chemo and radiation
have high HCG an/or AFP
What are characteristics of yolk sac tumor?
yellow, mucinous aggressive see schiller duval bodies = look like primitive glomeruli high AFP seen commonly in boys < 3 yo
What are characteristics of choriocarcinoma?
malignant
hematogenous spread to lungs and brain
high HCG
may cause gynecomastia or symptoms of hyperthyroidism
What 2 cancers have alpha fetoprotein [AFP] marker?
- embryonal and yolk sac
NOT seminoma or choriocarcinoma
What 3 cancers have bHCG marker?
- embryonal, choriocarcinoma, seminoma
high level –> causes nipple tenderness/gynecomastia
What does LDH tell you?
marker of bulk disease = not sensitive or specific for recurrence
elevated in seminomas
What is pattern of spread for testicular cancer?
local spread to epididymis and spermatic cord
retroperitoneal lymph nodes
lungs
lymph nodes in chest
What are survival rates of testicular cancer?
99% if localized
