Reproductive: Testicular neoplasms Flashcards
Germ cell tumors in men typically arise when?
age 15-34 y/o
What are the germ cell tumors of the testes?
seminoma; embryonal carcinoma; choriocarcinoma; yolk sac tumor; teratoma
What germ cell tumor presents w/ highest incidence in 4th decade? rarely presents?
seminoma => rarely infants
What are survival rates for seminomas? Why?
90% => rare metastasize as only 10% are anaplastic
What Tx for seminomas work?
high radiosensitive Tx
How does a embryonal carcinoma present?
aggressive, testicular enlargement in 20-30y/o
What is the survival rates for embryonal carinoma? Why?
5yr is 35% => 30% are metastatic at Dx
What lab test will confirm an embryonal carcinoma in a 20-30 y/o?
elevated AFP associated with quickly enlarging testicles
What makes embryonal carcinomas dangerous?
metastasize to nodes, lungs and liver;
less radiosensitive than seminomas
How are embryonal carcinomas treated?
orchiectomy and chemo
When will choriocarcinoma present and how?
men age 15-25 with gynecomastia or testicular enlargement
What labs will be present in choriocarcinoma?
elevated serum and urine hCG
Does choriocarcinoma metastasize frequently?
highly malignant => spreads hematogenously to lungs, liver, brain
How is choriocarcinoma treated?
orchiectomy and chemo
What is a rare germ cell tumor that typically presents in children and infants?
yolk sac tumor
What labs will be present in yolk sac tumor?
elevated AFP
Survival rate for yolk sac tumors? why?
50% => very aggressive and may be form of embryonal carcinoma
How does a teratoma present?
testicular mass at any age but more common in infants/children
Which germ cell tumor may lead to behavioral changes?
benign changes in children;
variable in adults
How should a teratoma be treated?
orchiectomy followed by chemo and radiation
What makes a teratoma neoplasm different than others?
variety of tissues => nerve, muscle, cartilage, hair
What is the survival rate for teratoma?
2yr is 70%
What are the non-germ cell tumors?
Leydig cell tumors;
Sertoli cell tumors;
Lymphoma
How can you differentiate Leydig from Sertoli tumors?
Leydig produces enough to cause endocrinologic changes => masculinization/feminization in children;
adults get gynomastia
What are the similarities of Leydig and sertoli tumors?
usually unilateral;
produce androgens/estrogen;
usually benign;
What is the most common testicular cancer in elderly men?
lymphoma => elderly men
Do lymphomas metastasize?
yes => rarely confined to testes
**testes drained by lymph directly to lumbar nodes
What is the difference in metastases of testicular neoplasms and scrotal disease?
test. neoplasms => lumbar nodes
scrotal disease => superficial inguinal nodes
