Testicular Tumours Flashcards
Give two reasons why a biopsy is not performed a testicle
If performed you’d Paul tumour out of testicle and seed scrotum - iatrogenic
Most testicular tumours are germ-cell and I’ll malignant
Patient presents with a firm and painless testicular mass that is not transilluminated what is the diagnosis?
Testicle tumour
What are the risk factors are germ-cell tumours
Cryptorchidism + Klinefelter syndrome
Are germ-cell tumour is benign or malignant?
All are malignant
What are the five germ-cell tumours
TECYS
Teratoma, embryonal carcinoma, choriocarcinoma, yolk sac tumour, seminoma
How do seminomas + non-seminimos differ
Seminoma =
Respond to radiotherapy
Metastasise late
Good prognosis
Nonseminomatous =
Variable response to treatment
Metastasise early
At cross-examination testicle revealed a homogenous mass with no haemorrhage or necrosis . What testiculate tumour is it
Seminoma = Rarely produce beta hCG
What is an embryonal carcinoma
What are its features?
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
What effect does chemotherapy have on embryonal carcinoma tumour?
Allows tumour to differentiate Eg teratoma
In embryonal carcinoma what Markers are elevated?
Alpha-fetoprotein
hCG
What is the most common testicular tumour in children
Yolk sac endodermal sinus tumour
On histology We see a glomeruloid-like structure what is this classically seen in?
Schiller-Duval body
Resemble yolk sac endodermal sinus tumour
What chemical Marker does the endodermal sinus tumour release
Alpha-fetoprotein
What is a choriocarcinoma
Malignant tumour of syncytiotrophoblast + cytotrophoblast i.e. placental-like but
NO VILLI!!!!!!!!!!!!!!!£?@),@6,@6,£!&!0£?@6:;”)”£?”&!@@!@!”!@!@!@!9!!!!!!!!!
In the choriocarcinoma which layer produces beta-hCG
Synctio trophoblast
A male presents with hyperthyroidism and gynaecomastia What tumour does he have?
Choriocarcinoma = syncytiotrophoblast + cytotrophoblast
Syncytiotrophoblast = increased beta HCG
Alpha-subunit of HCG similar to FSH/LH/TSH – >
HYPERthyroidism + gynaecomastia
Why do embryonal carcinoma + Choriocarcinoma tumours metastasise very early and quickly?
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
What Germ-cell tumour is benign in females but malignant in males
Teratoma
What is a teratoma?
Two of mature fetal tissue derived from two or three and embryonic layers
What’s tumours have an increase in both AFP + beta HCG?
Embryonal carcinoma
Teratoma
What is a mixed germ-cell tumour?
What is the prognosis based on?
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
A histologist sees Reinke eosinophilic cytoplasmic crystals . Whats the diagnosis
Leydig cell sex cord-stromal tumour
Are sex cords stromal tumour malignant or benign?
Benign
A 60-year-old man presents with a testicular tumour . What is this likely to be?
Testicular lymphoma usually
bilateral diffuse large B-cell type
Aggressive
