Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Renal > Testicular Cancer > Flashcards

Testicular Cancer Flashcards

1
Q

Classification of testicular cancer:
Name 2 main types, indicate which is most common
Name the subtypes

A 
Germ cell tumor (GCT) 95%
- Seminoma
- Embryonal carcinoma
- Teratoma
- Teratocarcinoma
- Choriocarcnioma
- Yolk sac tumours
Non-GCT 5%
- Leydig cell stromal tumour
- Gonadoblastoma
- Lymphoma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How does testicular cancer present? [4]

Describe what you would see on examination [5]

A

Usually just a painless testicular lump, may have:

  • Tender inflamed swelling
  • Trauma history
  • Metastatic symptoms (chest/bone/para-aortic lymph nodes) eg bone pain

OE:

  • non-tender testicular mass (note size, shape and consistency on palpation)
  • enlarged supraclavicular lymph nodes
  • hyperthyroidism
  • hydrocele
  • gynaecomastia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

DDX for testicular lumps? [4]

A

1) Cancer
2) Infection (Epididymo-orchitis)
3) Epididymal Cyst
4) Missed Testicular Torsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Risk factors for testicular cancer [8]

Peak age

A
  • 3rd decade (much younger than most cancers)
  • Caucasian
  • FMH/PMH
  • Infertility (3x)
  • Cryptorchidism
  • Klinefelters
  • Testicular atrophy 2* to trauma, hormones, viral orchitis
  • HIV infection
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What tests can be done for Testicular Cancer? [3]

A

MSSU
Testicular US/XR
Tumour Markers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What tumour markers do you look for and what type of cancer do they indicate? [3]

A
  • Alpha-fetoprotein (AFP) - Teratoma
  • BetaHCG (Human chorionic Gonadotrophin) - Seminoma
  • LDH (Lactate Dehydrogenase)) - Non-specific tumour marker
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Initial management of testicular cancer [2]- explain why it is done in this approach [2]
What are possible complications? [3]
When is investigation done? and why? [2]

A

Radical Inguinal Orchidectomy (may need biopsy of contralateral testis to check for cancer) - removal of testicle, spermatic cord and appendages
- Inguinal approach enables high ligation of testicular vessels and avoids exposure of another lymphatic field to the tumour)

Cx: post-op haemorrhage, infertility or subfertility

Ix: histological examination done post-orchiectomy as no biopsy would breach tunica albuginea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Prognosis for testicular cancer generally?

5 yr survival for Stage 1 vs Stage 4?

A

Very good
Stage 1 - 99% 5 yr survival
Stage 4 - 73% 5 yr survival

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Difference between grading and staging testicular cancer

A

Grade - Assesses agggression based on differentiation

Staging - Assesses spread based on pathology exam of testi, CTs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

4 Stages of Testicular Cancer?

Describe T1-4 staging of testicular cancer

A

1) Testis Disease
2) Infradiagphragmatic nodes
3) Supradiaphragmatic Nodes
4) Extralymphatic Disease

T1 = confined to testis
T2 = confined to testis with lymphovascular invasion or beyond tunica albuginea
T3 = invades spermatic cord, T4 = invades scrotum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Etiology [3]

A

Malignant transformation of carcinoma in situ occurs when growth beyond basement membrane occurs
Eventually replaces testicular parenchyma
Tunica albuginea is natural barrier to local spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Subsequent management depends on stage of testicular cancer. Give mx for following scenarios:

  1. Low stage and negative markers [2]
  2. Locally invasive, nodal disease, persistent markers, relapse on surveillance [2]
  3. Metastases
  4. Relapsing disease
A
  • low stage -ve markers - Surveillance, maybe RT/chemo
  • Nodal/relapse/persistant markers - BEP (BELOMYCIN, ETOPOSIDE and CISPLATIN) chemo and retroperitoneal lymph node dissection (non-seminoma germ cell tumour ONLY)
  • Metastases require BEP chemo
  • Relapsing disease: other chemo +/- stem cell support
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Penile cancer
Define
Spread
RF [4]

A

Rare SCC originating from epithelium of inner prepuce and glans

Spreads to deep and superficial inguinal LN then pelvic LN, distant spread to lung and liver

Risk factors

  • Phimosis, balanitis xerotica obliterans
  • HPV 16, 18, genital warts, HIV
  • Smoking
  • Pre-malignant conditions penile intraepithelial neoplasia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Penile cancer

  • Presentation [3]
  • Ix [2]
  • Mx: name 3 modalities
A

Presentation

  • Lump, ulcer, erythematous lesion
  • Bleeding, discharge
  • Itching, burning sensation

Ix: biopsy, MRI

Mx:

  • Surgery
  • Chemo
  • Premalignant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe surgical interventions of penile cancer in the following scenarios:

  • Small and superficial lesions [3]
  • Glandular and distal penile tumors [1]
  • Inguinal metastases [1]
A

o Small and superficial lesions: circumcision, wide local excision and epithelial ablative techniques
o Glandular and distal penile tumours: partial penectomy
o Lymphadenectomy: inguinal mets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly

Renal (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions