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MOHD Keystone exam 3 > Testicuar Cancer > Flashcards

Testicuar Cancer Flashcards

(66 cards)

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1
Q

chemotherapy associated with pulmonary fibrosis

A

bleomycin from BEP (bleomycin, etoposide, platinol)

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2
Q

chemo alternate to bleomycin

A

ifosfamide

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3
Q

most common solid tumor in men 20-34 y.o.

A

testicular cancer

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4
Q

accounts for 90-95% of testis cancers

A

Germ Cell tumors

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5
Q

two types of testicular germ cell tumors

A
  1. seminoma
  2. nonseminoma (NSGCT)
    * germ cells are pleuripotentia
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6
Q

5-10% testicular cancers

A
  • Leydig cell tumors
  • Sertoli cell tumors
  • Gonadoblastoma
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7
Q

cryptorchidism

A

undescended testis; risk factor for testicular cancer (3-14x^)

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8
Q

orchidopexy

A

placing testis in the scrotum; does decrease risk of testis cancer if pre-pubertal orchiopexy

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9
Q

histologic classification of germ cell tumors

A
  1. seminoma

2. NSGCT (teratoma, embryonal, choriocarcinoma, yolk sac)

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10
Q

the most rare germ cell tumor

A

yolk sac

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11
Q

5-10% of germ cell tumors

A

teratoma

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12
Q

S TECY

A

seminoma; teratoma; embyronal; choriocarcinoma; yolk sac

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13
Q

most common type of seminoma found in older (>50 y.o.) male

A

spermatocytic

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14
Q

prognosis of spermatocytic seminoma

A

favorable

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15
Q

seminoma with high bHCG production

A

anaplastic seminoma (30-36% bHCG production)

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16
Q

seminoma that is radiation sensitive

A

typical (classic)

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17
Q

T or F: bHCG and AFP are biomarkers of pure seminomas

A

false: pure seminomas never make AFP; (means some element of the tumor is NSGCT if AFP is present)

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18
Q

types of seminomas (3)

A
  1. typical = classic (85%)
  2. anaplastic (5-10%)
  3. Spermatocytic (2-12%)
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19
Q

NSGCT that is NOT chemosensitive

A

teratoma

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20
Q

tumor with >1 germ cell layer

A

teratoma (NSGCT)

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21
Q

invades tunica and cord structures

A

embryonal NSGCT

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22
Q

if >40% of tumor is ______, = a risk factor for nodal disease (very aggressive); a)teratoma, b)embryonal, c)chroiocarcinoma, d)yolk sac

A

embryonal

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23
Q

spreads hematogenously, not via LNs

A

pure chorio mets

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24
Q

most common testis tumor in kids

A

yolk sac tumor

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25
barrier to local growth of testicular tumor
tunica albuginea
26
incision for radical orchiectomy
inguinal (to prevent iatrogenic scrotal violation which may lead to inguinal mets)
27
regional lymphatic spread is typically to:
retroperitoneal lymph nodes
28
right teste 'landing zone' and cross-over mets
interaortocaval area; can met to L retroperitoneum
29
left teste 'landing zone' and cross-over mets
para-aortic area; does NOT typically cross-over to R
30
spread hematogenously with early mets to lung
choriocarcinoma
31
____% of NSGCT present with metastatic disease
50%
32
most common clinical symptom of testicular cancer
painless enlargement of testis (acute pain/swelling in 10%)
33
differential for abdominal pain in young man
TESTICULAR CANCER, appendicitis, etc.
34
differential for retroperitoneal mass
TESTICULAR CANCER, lymphoma, etc.
35
physical exam for suspected testicular cancer
testicular exam (firm, nontender, rock hard mass); abdominal exam (retroperitoneal LNs); distant adenopathy (supraclavicular, inguinal, axillary); gynecomastia (5%)
36
produced by yolk sac tumors and embyronal cancers (NSGCT)
AFP (NEVER in seminomas)
37
choriocarcinoma and 15% of seminomas produce:
choriocarcinoma
38
reflects tumor burden
LDH
39
Other labs to get in suspected testicular tumor
CBC (anemia), creatinine (renal failure); LFTs
40
tumor markers to measure in suspected testicular cancer
AFP, hCG, LDH, CBC/Cr/LFTs
41
confirms testicular mass and intra- vs extra-testicular
scrotal ultrasound
42
ALWAYS get this imaging before OR for orchiectomy
scrotal ultrasound
43
additional imaging for suspicious testicular mass
CXR - mets to lungs?; abdominal and pelvic CT (mets or retroperitoneal LN involvement)
44
pure seminoma histolgy, AFP negative, elevated b-hCG
pure seminoma tumor
45
mixed seminoma/nonseminoma tumors and seminoma histology, elevated AFP
NSGCT
46
T or F: treatment of primary tumor involves the following: 1. testicular mass biopsy 2. radical inguinal orchiectomy +/- testicular prosthesis
FALSE: treatment of primary tumor involves radical inguinal orchiectomy, NEVER testicular mass biopsy
47
treatment options for testicular tumor:
surveillance, chemo, radiation, surgery (RPLND)
48
mortality for advanced disease testicular cancer:
50% in 70s)
49
side effect of this chemotherapy includes renal insufficiency
etopside and cisplatin
50
side effect involves neuropathy, 35% ototoxicity, N/V
cisplatin
51
side effect of hemorrhagic cystitis
ifosfamide
52
side effects include renal insuff, myelosupression, alopecia, secondary leukemia
etopside
53
indications for radiation therapy
seminoma tumor (Not used for NSGCT); 26 Gy
54
most serious long-term side effects of chemo:
development of second malignancies
55
indication for complete bilateral RPLND
suspicious lymph node
56
RPLND may lead to 1) erectile problems, 2) ejaculation problems 3) both
ejaculation problems (sympathetic nerves may be injured in RPLND); erections are not an issue because nerves are near prostate
57
primary treatment for seminoma:
radiation
58
salvage therapy for seminoma
chemotherapy
59
"sticky" tumor in which RPLND is not indicated
seminoma
60
high stage seminoma (IIB, IIC, III) treatment:
chemotherapy: BEP (bleomycin, etoposide, cisplatin); 90% response
61
treatment for low stage NSGCT
Stage I: RPLND, surveillance, chemo; 75% stage 1 cured with orchiectomy
62
RF for microscopic mets in NSGCT
>40% embryonal component; lymphovascular invasion; T2
63
Growing teratoma syndrome
teratomas are not chemosensitive; NSGCT continues growing despite chemo
64
most common age group for testis cancer
young men
65
young man with scrotal and abdominal pain
think TESTICULAR CANCER
66
cure rates for testicular cancer
HIGH - many cases are localized at diagnosis; if regional or distant disease, are often responsive to multimodal thearpy

MOHD Keystone exam 3 (9 decks)

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