Testis, Scrotal Sac, and Epididymis Diseases Flashcards
Testicular tumors are most often of what origin?
Germ cell
Malignant testicular tumors are often of what origin?
Germ cell
Benign testicular tumors are often of what origin?
Sex cord-stromal tumors
What is the most common testicular cancer?
Seminoma
What is the most common risk factor for developing a testicular cancer?
Cryptorchidism
Testicular cancer most often metastasis to what lymph nodes?
Para-aortic
Detail the age at which following tumors are commonly seen: seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma.
Seminoma- young men and men >65 Embryonal carcinoma- Young men Choriocarcinoma- Young men Yolk sac tumor- Children under 4 Teratoma- all ages
What age range does the spermatocytic seminoma variant typically occur in?
Older individuals
Are most testicular tumors pure or mixed?
Mixed (60%)
Of pure testicular tumors, what is the most common type?
Seminoma
Describe the biphasic appearance of a seminoma.
Neoplastic cells resemble spermatogonia
Lymphocytic infiltrate
Describe the gross appearance of a seminoma.
Fish flesh appearance
Compare the chemosensitivity of embryonal carcinoma to teratoma.
Embryonal carcinoma is chemosensitive
Teratoma is chemoresistant
A teratoma of the testes has squamous cells present, what risk does this confer in terms of prognosis.
Teratomas have the potential to undergo malignant transformation, thus, squamous cells may develop into SCC
Cysts are a common feature of what type of testicular tumor?
Teratoma
What is the most common testicular tumor in children
Yolk sac tumor
What histologic finding is pathognomonic for a yolk sac tuor?
Schiller-Duval bodies
What tumor marker indicates a yolk sac tumor?
AFP
What tumor marker indicates choriocarcinoma?
hCG
What germ cell tumor of the testes has the worst prognosis?
Choriocarcinoma
What are the cellular components of a choriocarcinoma?
Syncytiotrophoblast
Cytotrophoblast
What testicular cancers can produce gynecomastia?
Choriocarcinoma (hCG is LH analog)
Leydig cell tumor
What is the most common testicular caner in men over 60?
Malignant lymphoma
Descent of the testes is divided into two phases, the transabdominal phase and the inguinoscrotal phase. What hormones are necessary for each phase?
Transabdominal phase- Mullerian inhibitory hormone
Inguinoscrotal phase- androgen and hCG dependent
Define cryptorchidism.
Incomplete or improper descent of the testis into the scrotal sac- most common GU disorder in male children
What is the most common site of cryptorchidism?
Inguinal canal
Spontaneous descent of cryptorchid testis may occur, at what point in time does spontaneous descent become uncommon?
3 months
What complications may arise if an undescended testis is not corrected?
Infertility- testicular atrophy (similar changes can occur in contralateral, normal testis)
Increased risk for cancer
What are common causes of orchitis?
Mumps
Syphilis
HIB
Extension of acute epidymitis
What are common causes of epididymitis in persons under 35?
N. gonorrhoeae
C. trachomatis
What are common causes of epididymitis in prsons over 35?
E. coli
Pseudomonas aeruginosa
Caseating granulomas found in the epididymis are associated with what pathogen?
Tuberculosis
What is the most common cause of L sided scrotal enlargement in adults?
Variocele
Where does the left spermatic vein drain?
L renal vein
Where does the right spermatic vein drain?
Vena cava
What diagnostic finding is key to checking for a testicular torsion?
Absent cremasteric sign- stroking inner thigh with tongue blade normally causes scrotum to retract
What is the most common causes of scrotal enlargement in children?
Hydrocele
