Other Neoplasms

Question 1

Penis neoplasms

Answer 1

1. Condyloma acuminatum - b

2. Squamous cell carcinoma - m

Question 2

Features of condyloma acuminatum

Answer 2

• lesions found on coronal sulcus, inner surface of prepuce
• clear vacuolation
• assoc w HPV types 6 & 11

Question 3

Features of squamous cell carcinoma of the penis

Answer 3

• circumcision is protective - rare among Muslims & Jews
• assoc w HPV types 16 & 18
• slow growing, locally invasive
• mets to inguinal/iliac lymph nodes - poor prog

Question 4

Features of testicular tumours

Answer 4

• mainly germ cell tumours (95%)
• epithelial tumours uncommon
• germ cell tumours mainly in young men, lymphomas in older men
• most post-pubertal tumours originate from intratubular germ cell neoplasia
• associated with cryptorchidism (undescended testes), genetics, testicular dysgenesis

Question 5

Testicular tumours

Answer 5

1. Germ cell tumours
   - Seminomatous
   - Non-seminomatous (NSGCT)
   - Mixed tumours
2. Teratoma

Question 6

Features of seminomatous germ cell tumours

Answer 6

• tend to remain localised for a long time, very radiosensitive
• spread by lymphatics to para-aortic nodes
• eg Seminoma (classical type) - commonest germ cell tumour, peak in 4th decade

Question 7

Features of NSGCT

Answer 7

• relatively radioresistant, metastasises early
• uses hematogenous route more commonly
• eg embryonal carcinoma - peak 20-30y
• eg yolk sac tumour/infantile embryonal carcinoma/endodermal sinus tumour - neoplastic germ cells differentiating along extra-embryonic lines

Question 8

Clinical features & tumour markers of testicular tumours

Answer 8

• painless enlargement of testis
• raised serum alpha-fetoprotein
• raised serum human chorionic gonadotropin β sub unit

Question 9

Features of teratoma

Answer 9

• contains a variety of mature and/or immature tissue types, most often from more than 1 germ layer
• may exist in combination with other germ cell tumours (mixed)