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UROLOGY > TESTICULAR TUMOURS > Flashcards

TESTICULAR TUMOURS Flashcards

1
Q

Mass in SCROTUM
🚦DIFFERENTIAL DIAGNOSIS🚦

🧠⚡SHOVE IT⚡

A

SHOVE IT:
1. Spermatocele
2. Hydrocele
3. Haematocele
4. Orchitis
5. Varicocele
6. Epidymal cyst
7. Indirect inguinal hernia
8. Torsion/ Tumor

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2
Q

Classification of TESTICULAR TUMOUR
🧠⚡ Non-seminomatous: CETY⚡

A
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3
Q

⚡⚡ MOST COMMON TESTICULAR TUMOUR

⚡⚡ MOST COMMON TESTICULAR TUMOUR IN CHILDREN

⚡⚡ MOST COMMON TESTICULAR TUMOUR IN ELDERLY

A

⚡⚡ MOST COMMON TESTICULAR TUMOUR
🎯 SEMINOMATOUS

⚡⚡ MOST COMMON TESTICULAR TUMOUR IN CHILDREN
🎯 YOLK SAC TUMOURS

⚡⚡ MOST COMMON TESTICULAR TUMOUR IN ELDERLY
🎯 LYMPHOMA

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4
Q

⚡⚡ MOST COMMON B/L TESTICULAR TUMOUR

A

Lymphoma

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5
Q

⚡⚡ MOST COMMON PRESENTATION OF TESTICULAR TUMOUR

A

Painless TESTICULAR Mass

Others:
✨ Abdominal Lump: Retroperitoneal Lymph node

✨ Cannon Ball Metastasis to Lung

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6
Q

HURRICANE TUMOUR

A

✨ Very aggressive CHORIOCARCINOMA
✨ 6 months: SURVIVAL TIME
✨ Exceeds its own blood supply
🎯 Testis Shrinks &
🎯 Metastasis to other organs

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7
Q

Sertoli cell tumour presents as
🧠⚡S for S⚡

Leydig cell tumour presents as
🧠⚡L⚡

A

🎯 Sertoli cell tumour presents as SILENT tumour ➡️ releases INHIBIN

🎯 LEYDIG cell tumour presents as
✨ Gyanecomastia
Estrogen & Androgen secreting

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8
Q

⭐ Maximum Alpha Fetoprotein is secreted by which TESTICULAR TUMOUR

⭐ ⭐ Maximum Beta HCG is secreted by which TESTICULAR TUMOUR

🧠⚡ In anticlockwise
AD
BC ⚡

A
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9
Q

FNAC (OR) TRANS-SCROTAL Biopsy is NOT DONE is SUSPECTED TESTICULAR TUMOUR?

A

DUE TO RISK OF UPSTAGING the Stage

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10
Q

CHEVASSU MANEUVER done in

A

Suspected TESTICULAR TUMOUR
⬇️
HIGH INGUINAL INCISION

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11
Q

WORK UP IN A SUSPECTED TESTICULAR TUMOUR

A
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12
Q

Usually TNM Staging is done for most tumours, TNMS staging is done for

A

TESTICULAR TUMOUR
S = Value of Tumour Markers (Post Orchidectomy Values)

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13
Q

1st DRAINING LYMPH NODE for TESTICULAR TUMOUR

A

Para-aortic Lymph node

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14
Q

🩺 IOC for STAGING of TESTICULAR CANCER

A

PET-CT

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15
Q

T STAGING of TESTICULAR TUMOUR

A

T1: Limited to TESTIS & EPIDIDYMIS ± Involvement of TUNICA ALBUGINA
✨ T1a: < 3cm
✨ T1b: > 3cm

T2: Limited to TESTIS & EPIDIDYMIS ± Involvement of TUNICA ALBUGINA ➕ TUNICA VAGINALIS ➕ Vascular/lymphatic Invasion

T3: Spermatic CORD Involvement ± Vascular/lymphatic Invasion

T4: Invades SCROTUM ± Vascular/lymphatic Invasion

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16
Q

N STAGING of TESTICULAR TUMOUR

A

N0 : No Regional LN Metastasis
N1: ≤ 5 LN size ≤ 2cm
N2: > 5 LN size > 2cm & < 5cm
N3: Size > 5cm

17
Q

M STAGING of TESTICULAR TUMOUR

A

M0: No distant Metastasis
M1A: Lung (OR) Non-regional Lymph nodes
M1B: Metastasis elsewhere

18
Q

T½ of
⭐ Beta HCG
⭐ AFP

A

⭐ Beta HCG
🎯 1-3 days

⭐ AFP
🎯 5-7 days

19
Q

AFP is NEVER RAISED in

A

Pure SEMINOMA

20
Q

Tumour Markers for SEMINOMA

🧠⚡TONKI ⚡

A
  1. Twelve p Isochromosome (12p)
  2. OCT3/4
  3. Nanog
  4. c-KIT
21
Q

ITGCN Can give rise to all TESTICULAR Tumours EXCEPT
🧠⚡STP ⚡

A
  1. Spermatocytic SEMINOMA
  2. Teratoma
  3. Pre-pubertal Yolk Sac Tumour
22
Q

Difference BETWEEN SEMINOMATOUS & NON-SEMINIMATOUS GCT

A
23
Q

💊💉 MANAGEMENT of NON-SEMINIMATOUS GCT
⭐ STAGE 1

A

Chemotherapy: BEP

24
Q

💊💉 MANAGEMENT of NON-SEMINIMATOUS GCT
⭐ STAGE 2

A

Induction CHEMOTHERAPY
⬇️ if LN ➕ & TUMOUR markers ➕
⬇️
RETROPERITONEAL LYMPH NODE DISSECTION

25
Q

💊💉 MANAGEMENT of NON-SEMINIMATOUS GCT
⭐ STAGE 3

A

Chemotherapy
⬇️ if LN ➕ & TUMOUR markers ➕
2nd LINE CHEMO
⬇️ if LN ➕ & TUMOUR markers ➕
Salvage RPLND

26
Q

💊💉 MANAGEMENT of STAGE 1 SEMINOMATOUS GCT

⭐ with GOOD PROGNOSTIC FACTORS
⭐ with BAD PROGNOSTIC FACTORS

A

⭐ with GOOD PROGNOSTIC FACTORS
🎯 SURVILLANCE

⭐ with BAD PROGNOSTIC FACTORS
🎯 Single Cycle of PLATINUM based CHEMOTHERAPY

27
Q

💊💉 MANAGEMENT of STAGE 2 SEMINOMATOUS GCT

🧠⚡Stage 2 = TESTIS ➕ LN belows diaphragm⚡

A

⭐ RADIOTHERAPY (30 Gy) to PARA-AORTIC LN
✨ Inverted Y Fashion
⬇️
⬇️ (residual LN ➕)
Chemotherapy

28
Q

💊💉 MANAGEMENT of STAGE 3 SEMINOMATOUS GCT

🧠⚡Stage 3 = TESTIS ➕ LN above diaphragm (METASTASIS)⚡

A

Chemotherapy (BEP)
⬇️ followed by
Radiotherapy

29
Q

BEP Regimen

A

Bleomycin
Etoposide
cisPlatin

30
Q

Lymph node dissection is VERY DIFFICULT in SEMINOMA
Why?

A

Adherent to VESSELS

31
Q

In RETROPERITONEAL LYMPH NODE DISSECTION, Always NERVE SPARING Technique must be done
Why?

A

To MAINTAIN ANTEROGRADE EJACULATION

32
Q

Role of METASTATECTOMY in TESTICULAR TUMOUR

A

Survival ⬆️ ⬆️ on removal of Mets

UROLOGY (12 decks)

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