testicular tumors/ Germ cell tumor of testis Flashcards
Epidemiology of testicular tummors
95-97% of all TT are Germ cell tumors
10% of all malignancies in the UGS
3-6% of all malignancies in men
1-3% of cases are bilateral
presenting ages = 20-40 y/o men
usually presents on the Right side
what % of all TT are Germ cell tumors
95-97%
what percentage do TT make up of malignancies in the UGS
10%
what percentage do TT make up of all malignancies in men
3-6%
what percentage of cases of TT are bilateral
2 types of presenting bilateral tumors
1-3%
Synchronous = present at the same time
Metachronous = Present at different times usually right side first d/2 cryptochordism. usuallly met from the 10 tumor in other side
abnormal undescended PW
presenting ages of TT
20-40 y/o men
What are the 4 RF of TT
which is the MC
what other pathology is assoc with it
-
Cryptochordmism
- __abdominal crypto= 1/20
- inguinal cyrpto = 1/80
- Testicular dysgenesis i. e Klinefelters
- Inguinal herina usually assoc w/ crypto
- Testicular Trauma leading to Induration
Pathological Classification of TT according to WHO 2016
-
Germ cell (mg)
-
Seminomatous (ClASp)
- Classical
- Spermatocytic
- Anaplastic
-
Non-seminomatuos (Choreo-TIME)
- Intracellular germ cell neoplasia
- Embryonal
- adult
- infantile
- Choriocarcinoma
- Teratoma
- Mixed
-
Seminomatous (ClASp)
-
Non Germ Cell (bg, rare, non clinical meaning)
- Leydig
- Sertoli
- Gonadoblastoma
types of Seminomatous Germ cell tumors
SEMINOMATOUS ClAsp
Classical
Spermatocytic
Anaplastic
types of Non-seminomatuos Germ cell tumors
Choreo-TIME
which has hematogenous spread
types of embryonal
types of tumors in mixed what’s the prog
- Intracellular germ cell neoplasia
-
Embryonal
- adult
- infantile e.g. Teiluris= quick death d/2 aggressive nature
-
Choriocarcinoma very small and aggressive. hematogenous spread
- Teratoma
- Mature
- Immature w/ malig component e.g. Teratocarcinoma
-
Mixed 60% have more than 1 histological types w/ unfavourable prognosis
- Seminoma combo w/ Embryonal
Non Germ Cell tumors (bg, rare, non clinical meaning)
SLG
- Leydig
- Sertoli
- Gonadoblastoma
what determines the clinical and pathological staging of TT
- TNM 2017
2.
what is the
AJCC
UICC
where are they accepted
when are they accepted world wide
American Joint Commitee on Cancer = accepted in US
Union International Comitte on Cancer = accepted in EU
if both are present they are accepted internationaly
what is the TNM 2017 system
what does N stand for
TNM 2017
gathers information about the the extent of a tumour to define the TNM category before and after surgery
N = regional LN centre of the specific tumor
what is the N (Regional LN centre of TT)
Lumbar Retroperitoinaeal L.N’S
below the kidney at the site of testes Embryological origin
- PreCaval
- ParaCaval
- IntraAortoCaval
- ParaAortic
- PreAortic
how do TT spread (met)
what’s the exception
Lymphogenous spread
except Choriocarcinoma (NSGCT) which has Hematogenous spread
Clinical Presentation of TT
- Painless testicular englarment
- Induration( localised hardening of soft tissue)
- Nodes in the testes
- Scrotal Mass ( 2 types dx by U.S)
- Intratesticular
- Extratesticular
3 phases of the evolution of TT
-
Latent Phase
- e.g. Intratubular GC neoplasia
- found incidentally by self palpaption, US
- Clinically manifested Phase
- Advanced Phase
dg of TT
dx dg of TT
epididymitis & testicular torsion
treatment of TT
how does histological report affect post op rx
specific rx for Choriocarcinoma
