testicular tumors Flashcards
where do testicular tumors arise from?
germ cells or sex-chord stroma
how do testicular tumors present?
as a hard, painless mass that cannot be transilluminated. most are malignant germ cell tumors.
do we biopsy testicular tumors?
never. can lead to scrotal seeding
how are germ cell tumors characterized?
seminomas or nonseminomas. most common type of tumor (95%). usually between 15-40. risk factors are klinefelters and cryptorchidism.
seminomas characteristics?
55% of tumors. mets late, highly responsive to chemo. excellent prognosis. malignant comprised of large cells with clear cytoplasm. they form a homogeneous mass without necrosis or hemorrhage. sometimes secretes beta-hCG.
what is the prognosis for seminoma
good because it responds to radiotherapy
embryonal testicular tumors?
they are nonseminoma. they are comprised of primitive, immature cells that form glands. they form hemorrhagic, necrotic masses. they are aggressive with early hematogenous spread. typically have AFP and beta-hCG.
what happens when embryonal tumors are subject to chemo?
they differentiate into another type. most common teratoma
yolk sac tumor?
malignant, most common tumor in children. commonly have schiller-duval bodies (glomerulus-like bodies). AFP characteristically elevated
choriocarcinoma?
cytotrophoblastic and syncitiotrophoblastic. this is placenta like tissue. spreads early via the blood. there is elevated beta-hCG. characteristically hyperthyroidism and gynecomastia.
teratoma characteristics
tumor of mature fetal tissue derived from two or three embryonic layers. malignant in males. AFP and hCG elevated.
sex-chord stroma tumors
usually benign, leydig cell usually produce androgens hat cause percocious puberty in children or gynecomastia in adults. REINKE CRYSTALS! sertolli are clinically silent and have a tubular look to them.
what is the most common cause of testiuclar mass in men >60?
often bilateral it is lymphoma! usually large B-cell type.
