Reproductive system disorders

Question 1

cryptorchidism

Answer 1

failure of one or both testes to descend into the scrotum

Question 2

Epididymo-orchitis

Answer 2

inflammation of the epididymis and the testes

Question 3

hydrocele

Answer 3

fluid-filled sac around the testes that causes swelling in the scrotum
common in new born leaves by 1st yr of life

Question 4

varicocele

Answer 4

enlargement of the veins of the scrotum

Question 5

CIS tumors of the penis (carcinoma in situ )

Answer 5

bowens disease
erythroplasia of queyrat (erythroplakia)
Bowenoid papulosis
leukoplakia

Question 6

bowen disease?

Answer 6

cis occur in follicle bearing epithelium such as on the penile shaft

Question 7

erythroplakia

Answer 7

cis occurring within the penile mucocutenous epithelium namely the glans and prepuce

Question 8

bowenoid papulosis

Answer 8

resembles cis, seen in young males, behaves in a benign fashion
multiple slightly elevated papule that are red to violet in color

Question 9

leukoplakia

Answer 9

rare condition
solitary or multiple white scaly
pre malignancy is the presence of dysplasia in 10-20 cases

Question 10

malignant tumors of the penis are?

Answer 10

primary SCC- 95%

others: basal CC, capos sarcoma, urethral carcinoma and metastases.

Question 11

clinical presentation of tumor of the penis

Answer 11

skin abnormality/palpable lesion on the penis
occurs at an avg age of 50+
uncommon in young males

common signs:
painless lump (25%)
ulcer (13%)
rash (6%)
bleeding (4%)
balanitis (4%)

inguinal lymphadenopathy is present in 30-60% at diagnosis

Question 12

penile SCC subclassification

Answer 12

palpable lesion (48-65%)- low grade, nuclear 
atypical and graduated keratinization, well differentiated carcinoma.

papillary tumors (5-15%)- not associated with HPV

warty tumor (7-10%)- cauliflower like cancer associated with HPV

basaloid tumors (4-10%)- HPV related cancer that present as ulcerated irregular mass

verrucous tumor (3-8%)- low grade and associated with broad pushing border instead of infiltrative growth.

sarcomatous tumor (less than 1%)- deeply invasive ulcerated or rounded polypoid masses.

Question 13

testicular tumor

Answer 13

germ cell tumor

sex cord stromal tumors

Question 14

germ cell tumor (GCT)

Answer 14

seminomatous tumor: seminoma-30s-50%
spermocytic seminoma

nonseminomatous tumor (NSGCT)

Question 15

Non seminomatous tumors

Answer 15

embryonal carcinoma
yolk sac (endodermal sinus) tumor
choriocarcinoma
mixed GCT with teratoma-45%
teratoma

Question 16

sex cord stromal tumor?

Answer 16

leydig cell tumor

sertoli cell tumors

Question 17

risk factors for testicular tumor

Answer 17

undescended testes (cryptorchidism)

genetic predisposition (isochrome of c12)

testicular dysgenesis: testicular feminisation

                                  klinefelters syndrome

Question 18

seminoma morphology

Answer 18

arise from germ cells
classical/typical seminoma: 
1. sheets of large uniform cells with clear cytoplasm, prominent nucleus with few mitosis
2. lymphocytic infiltration
3.fibrous septae

spermatocytic seminoma

1. medium sized cells
2. scattered giant cells
3. cells resembling secondary spermatocytes

Question 19

features of seminomas

Answer 19

• cut surface of tumor shows solid and gray white
• indolent
• –metastasizes to para arotic and retroperitoneal lymph nodes first
• radiosensitive
• –do not secrete biomarkers: HCG & AFP
• –stains positive for PALP

Question 20

embryonal carcinoma

Answer 20

• –ill defined invasive masses with hemorrhage and necrosis
• cells with glandular & papillary patterns
• –primitive glandular differentiation
• most often causes mixed tumors i.e with choriocarcinoma and yolk sac tumor

—secretes alpha fetoprotein AFP

Question 21

yolk sac tumor

Answer 21

• common in infants and children below 3
• in adults they are mixed with GCT
• –microscopic feature is presence of endodermal sinuses or schiller-duval bodies

—secretes AFP and alpha 1-antitrypsin globules

Question 22

choriocarcinoma

Answer 22

highly malignant
composed of cytotrophoblast and syncytiotrophoblasts

often small, detected as a palpable nodule
HGC is produced by snncytiotrophoblasts

Question 23

name the characteristics shared by NSGCT

Answer 23

cut surface is variegated with necrosis & hemorrhagic and cystic areas
spread very fast
early hematogenous spread
radioresistant
common produce tumor markers AFP,Hcg

Question 24

teratoma

Answer 24

—tumor arising fro totipotent germ cells
derived from all 3 germ layers
–mature teratoma show fully differentiated tissues like glands, squamous cels, keratin, skeletal tissue, fat, cartilage, muscle
–immature teratoma are composed of tissues which are primitive neuroectoderm

—all germ cells neoplasm are malignant except for teratoma in children which behaves benign

Question 25

which germ cell tumor is not malignnt

Answer 25

teratoma in children

Question 26

sex cord/srtomal tumor

Answer 26

arise from sex cord or gonadal stroma
leydig (stromal) & sertoli (sex cord)

the are usually benign

the secrete sex hormones which leads to feminization or masculinization

Question 27

sex cord/stromal tumors are malignant or benign ?

Answer 27

benign