Testicular Tumours

Question 0

Give two reasons why a biopsy is not performed a testicle

Answer 0

If performed you’d Paul tumour out of testicle and seed scrotum - iatrogenic

Most testicular tumours are germ-cell and I’ll malignant

Question 1

Patient presents with a firm and painless testicular mass that is not transilluminated what is the diagnosis?

Answer 1

Testicle tumour

Question 2

What are the risk factors are germ-cell tumours

Answer 2

Cryptorchidism + Klinefelter syndrome

Question 3

Are germ-cell tumour is benign or malignant?

Answer 3

All are malignant

Question 4

What are the five germ-cell tumours

Answer 4

TECYS

Teratoma, embryonal carcinoma, choriocarcinoma, yolk sac tumour, seminoma

Question 5

How do seminomas + non-seminimos differ

Answer 5

Seminoma =
Respond to radiotherapy
Metastasise late
Good prognosis

Nonseminomatous =
Variable response to treatment
Metastasise early

Question 6

At cross-examination testicle revealed a homogenous mass with no haemorrhage or necrosis . What testiculate tumour is it

Answer 6

Seminoma = Rarely produce beta hCG

Question 7

What is an embryonal carcinoma

What are its features?

Answer 7

Malignant tumour of immature primitive cells like embryonal cells

produce glands, form haemorrhagic mass+necrosis

Its aggressive
There is early haematogenous spread Because cells are primitive therefore programmed to move and spread rapidly

Question 8

What effect does chemotherapy have on embryonal carcinoma tumour?

Answer 8

Allows tumour to differentiate Eg teratoma

Question 9

In embryonal carcinoma what Markers are elevated?

Answer 9

Alpha-fetoprotein

hCG

Question 10

What is the most common testicular tumour in children

Answer 10

Yolk sac endodermal sinus tumour

Question 11

On histology We see a glomeruloid-like structure what is this classically seen in?

Answer 11

Schiller-Duval body

Resemble yolk sac endodermal sinus tumour

Question 12

What chemical Marker does the endodermal sinus tumour release

Answer 12

Alpha-fetoprotein

Question 13

What is a choriocarcinoma

Answer 13

Malignant tumour of syncytiotrophoblast + cytotrophoblast i.e. placental-like but

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Question 14

In the choriocarcinoma which layer produces beta-hCG

Answer 14

Synctio trophoblast

Question 15

A male presents with hyperthyroidism and gynaecomastia What tumour does he have?

Answer 15

Choriocarcinoma = syncytiotrophoblast + cytotrophoblast

Syncytiotrophoblast = increased beta HCG

Alpha-subunit of HCG similar to FSH/LH/TSH – >
HYPERthyroidism + gynaecomastia

Question 16

Why do embryonal carcinoma + Choriocarcinoma tumours metastasise very early and quickly?

Answer 16

Original carcinoma is programmed to move and spread rapidly

Synctio + cytotrophoblast are programmed to find blood vessels therefore metastasise very early. Generally have a small primary tumour in the testicle with a massive metastatic tumour in the body

Question 17

What Germ-cell tumour is benign in females but malignant in males

Answer 17

Teratoma

Question 18

What is a teratoma?

Answer 18

Two of mature fetal tissue derived from two or three and embryonic layers

Question 19

What’s tumours have an increase in both AFP + beta HCG?

Answer 19

Embryonal carcinoma

Teratoma

Question 20

What is a mixed germ-cell tumour?

What is the prognosis based on?

Answer 20

Where a patient can have For example A patient can have a Yolk sac tumour + choriocarcinoma

The prognosis is based on the cancer with the worst outcome e.g. in this case choriocarcinoma

Question 21

A histologist sees Reinke eosinophilic cytoplasmic crystals . Whats the diagnosis

Answer 21

Leydig cell sex cord-stromal tumour

Question 22

Are sex cords stromal tumour malignant or benign?

Answer 22

Benign

Question 23

A 60-year-old man presents with a testicular tumour . What is this likely to be?

Answer 23

Testicular lymphoma usually
bilateral diffuse large B-cell type
Aggressive