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Reproduction > Testicular Tumors > Flashcards

Testicular Tumors Flashcards

1
Q

What is a seminoma?

A

Undifferentiated germ cell tumor that accounts for half of all germ cell tumors.
Presents as a firm intratesticular poorly demarcated masss that bulges from the cut surface of the testis

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2
Q

Is seminoma common before puberty?

A

No, not found before puberty and is found in most patients between the ages of 25 to 55

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3
Q

What is the major type of seminomas? Which ones are rare?

A

90% are the classic type. Rare ones are anaplastic and spermatocytic seminomas.

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4
Q

How often is the entire testis replaced by the seminoma tumor?

A

In over half the cases

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5
Q

What is the appearance of testis afflicted by seminoma?

A

Yellow-white with rare focal areas of hemorrhage and necrosis

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6
Q

What do seminomas look display histologically?

A

They display solid nests of proliferating tumor cells b/w scattered fibrovascular trabeculae and lymphocytes

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7
Q

What is the cellular structure of seminomas?

A

Cells have well-defined borders with glycogen rich clear cytoplasm and normal appearing nuclei with coarse granular chromatin

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8
Q

Are seminomas sensitive to radiation?

A

Yes, exquisitely sensitive

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9
Q

What is the effectiveness of radiation treatment of seminomas? What about chemo therapy?

A

Results in five year survival rates of 85-95%.

Chemo is curative in over 90%

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10
Q

Are there any serologic tumor markers for seminoma?

A

None, unlike for other germ cell tumors

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11
Q

What is another term for Yolk Sac Tumor?

A

Endodermal sinus tumor

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12
Q

What is yolk sac tumor?

A

A tumor that enlarges the testes and presents as poorly defined, lobulated masses that are yellow-gray on cut section, with focal areas of hemorrhage and necrosis

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13
Q

How common is yolk sac tumor in adults?

A

Almost non-existant

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14
Q

What is the histology of yolk sac tumor?

A

Tumor consists of dilated tubular spaces lined by flattened cells w/ edematous stroma

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15
Q

What do yolk sac tumor cells surround?

A

A Schiller-Duval Body

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16
Q

What is a Schiller-Duval body?

A

A microcyst containing a glomerulus-like structure with a central fibrovascular core

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17
Q

What marker do yolk sac tumor cells contain?

A

AFP - alpha fetoprotein

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18
Q

What can the presence of AFP in yolk sac tumor cells be used for?

A

Diagnosis, and purposes of metastasis and monitoring of the disease.

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19
Q

Whereas, seminoma cells are undifferentiated, embryonal Carcinoma cells are __________

A

Differentiated

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20
Q

What is an embryonal carcinoma?

A

A small tumor that replaces the entire testis.

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21
Q

What is the appearance of embryonal carcinoma on sectioning?

A

Gray-white, poorly demarcated, and bulging, with varying degrees of hemorrhage and necrosis

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22
Q

How common is embryonal carcinoma?

A

Second most common germ cell tumor, accounting for 15-35% of these neoplasms

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23
Q

When do embryonal carcinoma occur?

A

Most are found between ages 20 and 35. Do not occur before puberty

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24
Q

Which is more aggressive and lethal, seminoma or embryonal carcinoma?

A

embryonal carcinoma

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25
Q

How often is the tunica albuginea and epididymis invaded in embryonal carcinoma?

A

20% of the cases

26
Q

What is the histology of embryonal carcinoma?

A

Exhibit variable patterns, forming sheets of cells, with clefts, acini, and papillary structures

27
Q

What is the quality of embryonal carcinoma cells borders?

A

They are indistinct, with dense nuclei and prominent nucleoli

28
Q

What are the nucleoli of embryonal carcinoma cells marked by?

A

Pleomorphism and mitotic activity.

29
Q

What are embryonal carcinoma tissues often admixed with?

A

Other tissues such as Choriocarcinoma and yolk sac tumor - therefore tumor markers may be positive

30
Q

Do embryonal carcinoma cells stain for beta-HCG and AFP?

A

Occasionally

31
Q

T/F At time of diagnosis of embryonal carcinoma, patients usually already have metastasis to lymph nodes and distant organs

A

T

32
Q

How effective is chemo therapy for embryonal carcinoma with no metastasis? W/ metastasis?

A

Have a very high cure rate. If metastasis then the cure rate drops

33
Q

What are the most frequent patterns of mixed germ cell tumors?

A
  1. Teratoma with embryonal (teratocarcinoma)
  2. Teratoma, embryonal carcinoma, and seminoma
  3. embryonal carcinoma and seminoma
34
Q

What is testicular teratoma?

A

When embryonal carcinoma undergo differentiation and become a teratoma

35
Q

What germs layers are found in testicular teratoma?

A

All three germ layers

36
Q

How frequent are testicular teratomas in children? In adults?

A

Almost half of germ cell tumors in infants and children.

In adults less than 5% of tumors

37
Q

What are the three classifications of testicular teratoma?

A
  1. Mature, immature, and malignant teratomas
38
Q

What are teratomas called when they arise from the ovary?

A

Dermoid cysts - the most common ovarian tumor in women of reproductive years

39
Q

What is the most important predictor of the biological behavior of a testicular teratoma?

A

Age of the patient

40
Q

Are teratomas malignant infants and children?

A

No, they are invariably benign. In adults, on the other hand, they are commonly malignant.

41
Q

What are mature teratomas?

A

A solid and multicystic lesion that enlarges the testis. The cut surface exhibits mucinous cysts, with solid cartilaginous and osseous foci

42
Q

What is the histology of mature teratomas?

A

Haphazard arrangement of cells and organoid structures such as neural skeletal bone, cartilage, thyroid, respiratory epithelium, squamous epithelium, GI tract epithelium and other tissues within a fibrous or myxoid matrix

43
Q

What are Leydig cell tumors?

A

Neoplasms that are functionally active secreting androgens, estrogens, or both

44
Q

When do Leydig cell tumors occur?

A

Boys older than 4 years of age and men in their 3rd to 6th decades

45
Q

What is the appearance of Leydig cell tumors?

A

Well-circumscribed and encapsulated

46
Q

Tumor reveals _____ of polygonal cells with abundant ________ cytomplasm

A

sheets; eosinophilic

47
Q

How malignant are Leydig cell tumors?

A

90% are benign with endocrine effects

48
Q

What are the endocrine effects of Leydig cell tumors?

A

Causes precocious physical and sexual development in prepubertal boys, or feminization and gynecomastia are seen in other adults.

49
Q

What are Sertoli cell tumors?

A

Is a sex cord-gonadal stromal tumor that are 80% benign

50
Q

When do Sertoli cell tumors develop?

A

In the first four decades of life

51
Q

What is the appearance of Sertoli cell tumors?

A

Well-circumscribed, yellow-gray solid tumors. Have a tubular arrangement with solid cords of cells with a fibrous trabecular network

52
Q

What brings Sertoli cell tumors to medical attention?

A

A mass in the scrotum or endocrine effects (gynecomastia).

53
Q

How can sertoli and leydig cell tumors be cured?

A

Orchiotomy is curative

54
Q

What is a testicular choriocarcinoma?

A

A highly malignant testicular tumor, which represents germ cell extraembryonic differentiation to the components of the placenta, namely cyto- and syncytiotrophoblast

55
Q

Does testicular choriocarcinoma cause testicular enlargement?

A

No enlargement and is detected only as a small painless nodule

56
Q

What does the cut surface of a testicular choriocarcinoma contain?

A

Marked hemorrhage and necrosis

57
Q

Where are trophoblastic tissues found microscopically in a testicular choriocarcinoma?

A

in areas of hemorrhage

58
Q

What are syncytiotrophoblasts?

A

Large multinucleated giant cells with abundant vacoulated cytoplasm

59
Q

What does the cytoplasm of syncytiotrophoblast contain?

A

hCG.

60
Q

What are cytotrophoblasts?

A

Polygonal cells, with round, hyperchromic nuclei and sparse cytoplasm

61
Q

How frequent are pure tumors of testicular choriocarcinoma?

A

They are rare and mostly observed as a component of a mixed germ cell tumor

62
Q

How do testicular choriocarcinomas disseminate to the lungs?

A

by hematogenous routes (via blood)

Reproduction (10 decks)

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