Testicular Tumors

Question 1

What is the most common type of testicular tumor?

Answer 1

Germ cell tumors

Question 2

A majority of the tumors in this deck are of what type?

Answer 2

Germ cell tumors

Question 3

Germ cell (testicular) tumors usually occur in what age group/race?

Answer 3

15-45 year old white males

Question 4

What chromosomal abnormality is present with a Seminoma?

Answer 4

Reduplication of the short arm of chromosome 12

Question 5

What do the cells look like with Seminomas?

Answer 5

Polyhedral with clear cytoplasm that contains glycogen and 1-2 prominent nucleoli

Question 6

What cells are present with Seminomas?

Answer 6

Syncytiotrophoblasts

Question 7

What 3 stains will be (+) with a Seminoma?

Answer 7

(+) KIT, OCT3/4, Podoplanin

Question 8

Do Seminomas commonly involves hemorrhage or necrosis?

Answer 8

No

Question 9

What chromosomal abnormality is present with Spermatocytic Tumors?

Answer 9

Gain of chromosome 9q

Question 10

Spermatocytic Tumors have 3 cells present. What are they?

Answer 10

1. Medium cells
2. Smaller cells with dense chromatic
3. Scattered giant cells

Question 11

Embryonal Carcinomas are more aggressive tumors. What invasion is commonly seen with them?

Answer 11

Vascular/lymphatic invasion

Question 12

Are foci of hemorrhage or necrosis seen with Embryonal Carcinomas?

Answer 12

Yes

Question 13

Embryonal Carcinomas have what 2 (+) stains?

Answer 13

(+) OCT3/4, Cytokeratin

Question 14

What is a testicular tumor that can present before puberty? – most common one

Answer 14

Yolk Sac Tumor

Question 15

If a Yolk Sac Tumor is pre-pubertal it is better off. What is NOT associated with?

Answer 15

NOT associated with germ cell elements or germ cell neoplasia in situ

Question 16

What is a defining feature of Yolk Sac Tumors?

Answer 16

Schiller-Duval bodies (endodermal sinuses)

== Look like glomeruli!

Question 17

Schiller-Duval bodies are seen with what germ cell tumor and what do they look like?

Answer 17

Yolk Sac Tumors

– look like glomeruli

Question 18

What 3 stains will be (+) with Yolk Sac Tumors?

Answer 18

(+) AFP, alpha1 antitrypsin, cytokeratin

Question 19

Choriocarcinomas are highly malignant tumors, yet small. What is very elevated in the serum?

Answer 19

Increased hCG

Question 20

What 2 cell types are present with Choriocarcinomas?

Answer 20

Syncytiotrophoblasts

Cytotrophoblasts

Question 21

What do each of the cell types look like/contain with Choriocarcinoma?

Answer 21

Syncytiotrophoblasts – eosinophilic with hCG

Cytotrophoblasts – smaller with clear cytoplasm

Question 22

What stain will be (+) with Choriocarinomas?

Answer 22

(+) hCG

Question 23

What defines a Teratoma?

Answer 23

Components of more than 1 germ cell layer

Question 24

What is the second most common germ cell (testicular) tumor that can occur in children?

Answer 24

Teratoma

Question 25

What is the symptom of germ cell testicular tumors?

Answer 25

PainLESS enlargement of the testis

Question 26

What is the symptom of germ cell testicular tumors?

Answer 26

PainLESS enlargement of the testis

Question 27

What diagnostic test should you NOT do with germ cell testicular tumors?

Answer 27

Biopsy --> risk of tumor spillage

Question 28

If germ cell testicular cancers are going to spread via the lymphatics, where will they likely go first?

Answer 28

Para-aortic nodes

Question 29

If germ cell testicular cancers are going to spread via the blood, where will they likely go first?

Answer 29

Lungs

Question 30

What are 2 Sex Cord-Gonadal Stoma Tumors of the testes?

Answer 30

Leydig cell tumors | Sertoli cell tumors

Question 31

What are 2 Sex Cord - Gonadal Stroma Tumors of the testes?

Answer 31

Leydig cell tumors | Sertoli cell tumors

Question 32

What do leydig cell tumors often elaborate?

Answer 32

Androgens, estrogens, corticosteroids

Question 33

What are the possible symptoms of Leydig Cell Tumors?

Answer 33

Testis swelling, gynecomastia and early sexual development

Question 34

What are the possible symptoms of Leydig Cell Tumors?

Answer 34

Testis swelling, gynecomastia, early sexual development

Question 35

How do Leydig Cell tumors look?

Answer 35

Golden brown

Question 36

Leydig Cell tumors are often round with eosinophilic cytoplasm. What things can the cytoplasm contain?

Answer 36

Lipids Vacuoles Lipofuscin pigment Rod shaped crystalloids of Reinke

Question 37

What is a defining feature found in the cytoplasm of Leydig Cell tumors?

Answer 37

Rod shaped crystalloids of Reinke

Question 38

What is different about Sertoli Cell tumors compared to leydig cell tumors?

Answer 38

Sertoli cell tumors are hormonally silent | -- just testicular mass present

Question 39

Symptom of Sertoli Cell tumors?

Answer 39

Testicular mass only | -- no hormone changes unlike leydig cell tumors

Question 40

How are the cells arranged with Sertoli Cell Tumors?

Answer 40

Cord-like trabeculae

Question 41

What 3 things and mutation are Sertoli Cell Tumors associated with?

Answer 41

Carney complex --> PRKAR1A mutations Peutz-Jeghers syndrome FAP

Question 42

Testicular Lymphomas, are they often unilateral or bilateral and what structure is usually involved?

Answer 42

Bilateral | -- spermatic cord involved

Question 43

What is the con of Testicular Lymphomas presentation?

Answer 43

Usually disseminated at the time of detection

Question 44

Testicular Lymphomas have a high propensity for what site where they like to recurr?

Answer 44

CNS

Question 45

(+) hCG

Answer 45

Choriocarcinoma

Question 46

(+) AFP, alpha1 antitrypsin, cytokeratin

Answer 46

Yolk Sac Tumor

Question 47

(+) OCT 3/4, cytokeratin

Answer 47

Embryonal Carcinoma

Question 48

(+) KIT, OCT 3/4, podoplanin

Answer 48

Seminoma

Question 49

Gain of Chromosome 9q

Answer 49

Spermatocytic tumors

Question 50

Reduplication of short arm of Chromosome 12

Answer 50

Seminoma