Reproductive: Testicular neoplasms

Question 1

Germ cell tumors in men typically arise when?

Answer 1

age 15-34 y/o

Question 2

What are the germ cell tumors of the testes?

Answer 2

seminoma; embryonal carcinoma; choriocarcinoma; yolk sac tumor; teratoma

Question 3

What germ cell tumor presents w/ highest incidence in 4th decade? rarely presents?

Answer 3

seminoma => rarely infants

Question 4

What are survival rates for seminomas? Why?

Answer 4

90% => rare metastasize as only 10% are anaplastic

Question 5

What Tx for seminomas work?

Answer 5

high radiosensitive Tx

Question 6

How does a embryonal carcinoma present?

Answer 6

aggressive, testicular enlargement in 20-30y/o

Question 7

What is the survival rates for embryonal carinoma? Why?

Answer 7

5yr is 35% => 30% are metastatic at Dx

Question 8

What lab test will confirm an embryonal carcinoma in a 20-30 y/o?

Answer 8

elevated AFP associated with quickly enlarging testicles

Question 9

What makes embryonal carcinomas dangerous?

Answer 9

metastasize to nodes, lungs and liver;

less radiosensitive than seminomas

Question 10

How are embryonal carcinomas treated?

Answer 10

orchiectomy and chemo

Question 11

When will choriocarcinoma present and how?

Answer 11

men age 15-25 with gynecomastia or testicular enlargement

Question 12

What labs will be present in choriocarcinoma?

Answer 12

elevated serum and urine hCG

Question 13

Does choriocarcinoma metastasize frequently?

Answer 13

highly malignant => spreads hematogenously to lungs, liver, brain

Question 14

How is choriocarcinoma treated?

Answer 14

orchiectomy and chemo

Question 15

What is a rare germ cell tumor that typically presents in children and infants?

Answer 15

yolk sac tumor

Question 16

What labs will be present in yolk sac tumor?

Answer 16

elevated AFP

Question 17

Survival rate for yolk sac tumors? why?

Answer 17

50% => very aggressive and may be form of embryonal carcinoma

Question 18

How does a teratoma present?

Answer 18

testicular mass at any age but more common in infants/children

Question 19

Which germ cell tumor may lead to behavioral changes?

Answer 19

benign changes in children;

variable in adults

Question 20

How should a teratoma be treated?

Answer 20

orchiectomy followed by chemo and radiation

Question 21

What makes a teratoma neoplasm different than others?

Answer 21

variety of tissues => nerve, muscle, cartilage, hair

Question 22

What is the survival rate for teratoma?

Answer 22

2yr is 70%

Question 23

What are the non-germ cell tumors?

Answer 23

Leydig cell tumors;
Sertoli cell tumors;
Lymphoma

Question 24

How can you differentiate Leydig from Sertoli tumors?

Answer 24

Leydig produces enough to cause endocrinologic changes => masculinization/feminization in children;
adults get gynomastia

Question 25

What are the similarities of Leydig and sertoli tumors?

Answer 25

usually unilateral;
produce androgens/estrogen;
usually benign;

Question 26

What is the most common testicular cancer in elderly men?

Answer 26

lymphoma => elderly men

Question 27

Do lymphomas metastasize?

Answer 27

yes => rarely confined to testes

**testes drained by lymph directly to lumbar nodes

Question 28

What is the difference in metastases of testicular neoplasms and scrotal disease?

Answer 28

test. neoplasms => lumbar nodes

scrotal disease => superficial inguinal nodes