Testicular Tumors Flashcards
NAme the germ cell testicular tumors
- Seminoma
- Embryonal Carcinoma
- Yolk sac tumors
- Choriocarcinoma
- Teratoma
Risk factors for germ cell tumors
- Cryptochidism
- Prior TGCT
- Fam hx
- Infertility
Intratubular Germ Cell Neoplasia
-Adj to all germ cell tumors in adults, except spermatocytic seminoma
Seminoma
-Most common pure germ cell tumor composed of relatively uniform cells with abundant clear cytoplasm, well defined cell borders and nuclei with one or more prominent nucleoli
What is seminoma analogous to in females?
Dysgerminoma
Seminoma: presentation
- Most common painless testicular mass
- Unilateral
- Bulky mass
- Homogeneous
- Gray white
- Lobulated
- Devoid of hemorrhage and necrosis
Seminoma: histology
- Sheets of uniform cells
- Divided into poorly demarcated lobules by delicate septa of fibrous tissue, septa are infiltrated by T cells
- Large and round cells
- Clear and watery cytoplasm
- Large, central nucleus
- Prominent nucleolus
- May contain granulomas*
- May have syncytiotrophoblasts so serum hCG may be elevated (less that choriocarcinoma though)
Seminoma: treatment
- Good prognosis
- Stage I: orchiectomy and radiation
- Stage II: radical orchiectomy plus inguinal and radiation or combo chemo
- Stage III: Radical inguinal orchiectomy and multidrug chemo
Embryonal Carcinoma
Germ cell tumor composed of cells with epithelial appearance and marked cytologic atypia
Embryonal Carcinoma: gross
- Poorly demarcated
- Foci of necrosis and hemorrhage
- Extra testicular involvement
Embryonal Carcinoma: prognosis
Poor
Yolk Sac Tumor
Germ cell tumor characterized by variety of growth patterns that recapitulate yolk sac, allantois, and extra embryonic mesenchyme
Yolk Sac Tumor: incidence
Common pediatric cancer, rare in adults
Yolk Sac Tumor: presentation
- non symptomatic rapid testicular enlargement
- non encapsulated
- hemorrhagic, yellow, white, myxoid gelatinous
Yolk Sac Tumor: histologic
- AFP pos tumor (alpha fetoprotein)
- Schiller duval body
- Intracellular eosinophilic globules
Yolk Sac Tumor: treatment
-Take it out
Choriocarcinoma
Germ cell tumor composed of mononucleated cytotrophoblast and multinucleated syncytiotrophoblast
Choriocarcinoma: epi
- Usually part of a mixed tumor
- Young adults 25-30=most common
Choriocarcinoma: presentation
- Aggressive, but small
- Hemorrhagic and necrotic
- Metastasis widespread
Choriocarcinoma: Lab tests
High hCG levels
Choriocarcinoma: prognosis
Bad, hCG levels correlate with prognosis
Choriocarcinoma: treatment
Take it out and chemo
Choriocarcinoma: histology
Syncytiotrophoblast make giant cells
Teratoma
Tumors with more than one somatic tissue of different germinal layers. Second most common childhood germ cell tumor. Children <4 and adults between 20 and 40 get them
