Lecture 11.2: Male Genital Tract Tumours Flashcards
What Tumours can occur in the Male Reproductive System? (8)
- Prostate Adenocarcinoma
- Penis Squamous Cell Carcinoma
- Testis Germ Cell Tumours
- Urethra Transitional Cell Carcinoma
- Penis Benign Warts – Squamous Papilloma
- Scrotum Squamous Cell Carcinoma
- Inflammatory Mass Lesions simulating a tumour
- Invasion from Local Cancer
What are the 3 Zones of the Prostate?
- Central Zone
- Transition Zone
- Peripheral Zone
What can occur in the Transitional Zone of the Prostate?
- Benign Prostate Hyperplasia (BPH)
- Squeezes the urethra
What zone of the prostate do cancers occur in?
The Peripheral zone
What is the structure of the epithelium of the prostate gland?
Double layered epithelium:
* Inner Secretory (makes PSA)
* Outer Basal Cells
What happens to the double layer epithelium of the prostate in cancer?
The 2-layer morphology is lost
Effect of BPH on Urethra: Early BPH
Prostate enlargement causes urethral constriction
Effect of BPH on Urethra: Moderate BPH
Urethra is narrowed by benign growth of the prostate
Effect of BPH on Urethra: Advanced BPH
- Urethra is nearly fully obstructed
- Causes thickened bladder wall
- Can lead to bladder diverticula or stones
Management of BPH (3)
- Resection of Prostate
- Finasteride
- Alpha Blockers
How do Alpha Blockers help manage BPH?
These medications relax the muscle of the prostate and bladder neck, which allows urine to flow more easily
Risk Factors for Prostatic Cancer
- Age
- Ethnicity: African-American
- Family History
- Several Genetic Links
- Diet
Why do Eunuchs not get Prostate Cancer?
Chemically shutting down or surgically removing the main source of testosterone—the testes—can slow the spread of prostate cancer
Signs and Symptoms of Prostate Cancer (7)
- Asymptomatic in Early Stage
- Trouble Urinating
- Polyuria
- Decreased force of Urination
- Difficulty starting or stopping urine stream
- Blood in semen & urine
- Pain or discomfort in the pelvic area
- Bone pain = metastases
How can Prostate Adenocarcinoma spread? (3)
- Direct local invasion (seminal vesicles & bladder base)
- Blood stream
- Lymphatics
Gleason Pattern Scale
1: Small Uniform Glands
2: More space between glands
3: Distinct infiltration of cells from gland at margins
4: Irregular masses of neoplastic cells with few glands
5: Lack of or occasional glands, sheets of cells
Prostate Cancer TNM Staging: T1 to T4
T1 = incidental finding
T2 = confined to prostate
T3 = extension outside
T4 = direct invasion of contiguous organs
Why is PSA not a good test for diagnosis of Prostatic Cancer?
PSA levels can be raised due to several reasons, including infection, trauma, BPH, UTIs and prostate cancer
What Neoplasm can occur in the Penis? (4)
- Squamous Papilloma (condyloma, wart)
- Carcinoma in situ
- Bowen’s Disease
- Invasive Squamous Cell Carcinoma
Classic Microscopic Features of Malignancy (6)
- Cellular Atypia
- Large Cells
- Bizarre Nuclei
- Prominent Nucleoli
- Atypical Mitoses
- Apoptoses
Risk Factors for Penile Carcinoma (6)
- HPV 16 infection
- HIV infection (prognosis worsened)
- Not circumcised
- Hygiene
- Specific infection risk
- Cigarette smoking
Germ Cell Tumours of the Testicles (5)
- Seminoma
- Embryonal Carcinoma
- Yolk Sac (endodermal sinus) Tumour
- Choriocarcinoma
- Teratoma
Sex Cord-Stromal Tumours of the Testicles (2)
- Leydig Cell Tumour
- Sertoli Cell Tumour
Pathogenesis of Testis Tumours (3)
- Cryptorchidism (undescended testis)
- Dysgenesis of the testis
- Inherited genetic factor
How does a Seminoma Present?
- Presents as a mass in the testis
- Soft white fleshy mass
Management of Seminoma
- One of the most curable of cancers
- Excision of the whole testis
- Exquisitely radio- and chemotherapy sensitive
Leydig Cell Tumour
- Small tumours
- Endocrine secreting – androgens, sometimes
oestrogens - Gynaecomastia; precocious puberty
- 10% are malignant
