Penile, Testicular and Renal Tumors Flashcards
Epidemiology of penile cancer
- 2-5% of urogenital tumors
- higher risk over 60yrs
Etiology of penile cancer
- recurrent inflammation
- poor hygiene
- HPV
- sexual activity
Histology of penile cancer
- SCC (>95%): HPV or inflammation
- premalignant lesions: giant condyloma, bowen’s disease, erythroplasia of Queyrat
Symptoms of penile cancer
- hard, exophytic lump
- pain
- itching
- ulceration
- bleeding
- urethral fistula
Diagnosis of penile cancer
- medical history
- physical examination
- check inguinal lymph nodes
- Lab: urine + LDH
- biopsy
- pelvic US
- MRI
- CT (X-ray for bone spread)
- ureteroscopy
- cystoscopy
Radiation therapy for penile cancer
- Tis: teletherapy 50-66 Gy
- T1-T4: brachytherapy boost
- LDR brachytherapy (5-6 days) or HDR brachtherapy (5-6 weeks)
- palliative
Surgical therapy for penile cancer
- superficial tumor: laser + skin graft, topical 5-FU
- T1 preputium: wide local excision + circumcision
- T1 glans: glansectomy, partial penectomy, total penectomy
Pharmacological therapy for penile cancer
- vincristine
- bleomycin
- MTX (methotrexate)
- cisplatin
- 5-FU
- cyclophosphamide
Epidemiology of testicular cancer
1-2% of all malignant tumors in males
incidence group:
- 0-5 yrs
- 15-35 yrs
- 40-60 yrs
Etiology of testicular cancer
increased risk in cryptorchidism: testes fail to descend into the scrotum
Histology of testicular cancer
- sex cord stromal tumor
- germ cell tumors:
- seminoma: most common, metastasizes to lymph nodes and bone
- embryonal carcinoma: 15-35 years, metastasizes to lungs and liver; elevated AFP
- choriocarcinoma: metastasizes to lung, liver, brain; gynecomastia
- yolk sac carcinoma: infants; elevated AFP
- teratoma: contains ecto-, meso-, and endoderm
Symptoms of testicular cancer
- testicles become swollen, fuller, and harder
- pain
- acute epididymis
- palpable lymph nodes
Diagnosis of testicular cancer
- testicular US
- thoracic/abdominal/pelvic CT for metastasis
- tumor markers: b-HCG, AFP, NSE
- possible surgical exploration
Radiotherapy for testicular cancer
- seminomas: very radiosensitive; metastatic RT to lymph nodes
- nonseminomas: not radiosensitive but chemosensitive
Surgical therapy for testicular cancer
- high castration rate
- radical type of retroperitoneal lymphadectomy (nerve sparing) + ipsilateral illiac dissection in stages IIA
Pharmacological therapy for testicular cancer
carboplatin (postop. and post radiotherapy)
Epidemiology of renal cancer
- 3-5% of all tumors
- 7th most frequent in men
- 10th most frequent in women
Etiology of renal cancer
- passive smoking
- chemicals
- risk factors: hypertension, obesity, kidney failure, renal cystic disease, dialysis, transplantation
Histology of renal cancer
- renal cell carcinoma, adenocarcinoma (80-90%)
- papillary carcinoma (10%)
- chromophobe RCC (5%)
Symptoms of renal cancer
- asymptomatic
- accumulation of HCG, renin, insulin
- increased ESR
- hypertension
- weight loss
- anemia
- fever
- lower back pain
- macroscopic hematuria
- papable abdominal swelling
Diagnosis of renal cancer
- US
- CT
- CT angiography
- thoracic CT
Radiotherapy for renal tumors
- adjuvant: not recommended if resectable
- palliative: if metastatic
Surgical therapy for renal cancer
curative aim on non-metastatic tumors: partial or total nephrectomy (+ adrenal gland resection if upper part is affected)
Pharmacological therapy for renal cancer
- chemotherapy: adriamycin
- hormonal therapy: progestins
- targeted therapy: bevacizumab + temsirolimus (mTOR inhibitor)
- immunotherapy: pembrolizumab
