Testicular cancer

Question 1

What are the different types of germ cell tumours and non-seminomatous germ cell tumours of testes?

Answer 1

GCT:
Seminoma (most common type)

NSGCT:

1. Embryonal carcinoma
2. Teratoma
3. Yolk sac carcinoma
4. Choriocarcinoma

Question 2

Which testicular cancer has the best and worst prognosis?

Answer 2

Best: seminoma (also most radiosensitive; 99% cured with stage 1 disease)

Worst: choriocarcinoma

Question 3

Describe macroscopic morphology of seminoma.

Answer 3

Arises from the germinal epithelium of seminiferous tubules.

Solid white tumour without haemorrhage or necrosis. Tunica albiguinea is intact.

Question 4

What is the most common testicular cancer in children <4?

Answer 4

Yolk sac (endodermal sinus tumour)

Question 5

What is the characteristic cellular structure seen in yolk sac tumour?

Answer 5

Schiller-Duval bodies

A central vessel surrounded by tumor cells, and the whole structure being contained in a cystic space.

Question 6

What are tumour markers of testicular cancer?

Answer 6

β-hCG, AFP and LDH.

Question 7

Which testicular cancer does not produce any tumour markers?

Answer 7

Teratoma

Question 8

Is teratoma malignant in children or adults?

Answer 8

Adults

Question 9

What are some examples of sex cord stromal tumours?

Answer 9

• Leydig cell carcinomas (produces Reinke crystals)

- Sertoli cell carcinoma (clinically silent)

Question 10

What is cryptorchidism?

Answer 10

One or more testes failing to descend ㅡ a risk factor for testicular cancer.

Question 11

What is Klinefelter syndrome?

Answer 11

Abnormal testicular development, resulting in gynaecomastia, increased risk of breast cancer and GCT mediastinal.

Question 12

What is Kallmann syndrome?

Answer 12

Failure of migration of GnRH secreting cells into hypothalamus.

Characteristically anosmia and failure to start puberty.

Question 13

What is hypospadias?

Answer 13

Developmental abnormality of the penis.