Testicular 2 Flashcards
Biggest risk factor for testicular cancer
Cryptorchidism
Genetic aberration commonly seen in testicular GCTs?
Isochromosome 12p
For mixed GCT, at what percentage of nonseminomatous pathology has to be present for the tumor to be classified as a nonseminoma?
1%.
Any amount of nonseminoma means it’s classified as nonseminoma
What STM is not produced by seminoma?
AFP
Half life of AFP
7 days
Half life of bHCG
3 days
Extremely high levels of bHCG, what cancer is that suggestive of?
Choriocarcinoma
Who should get brain MRI?
Predominance of choriocarcinoma
Extensive lung mets
Mets to organs other than lungs
Super high hCG or AFP
STM staging S1
AFP <1000
bHCG <5000
LDH <1.5x ULN
STM staging S2
AFP 1000 - 10,000
BHCG 5,000 - 50,000
LDH 1.5 - 10x ULN
STM staging S3
AFP >10,000
BHCG >50,000
LDH >10x ULN
What are risk factors for recurrence
Embryonal
LVI
What is special about the treatment of stage IS?
Treated like Stage III
Tany N0 M0 S1-3
Elevated STM after surgery means there’s likely disseminated disease
Mets to what location have a better prognosis?
Lungs
What makes disseminated seminoma intermediate risk?
Mets to site other than lungs
***STMs do not play a role
What makes disseminated seminoma poor risk?
Doesn’t exist
What are features of good risk nonseminoma? (2)
Mets to nodes and/or lungs
S0-1