Testis, Scrotal Sac, and Epididymis Diseases

Question 1

Testicular tumors are most often of what origin?

Answer 1

Germ cell

Question 2

Malignant testicular tumors are often of what origin?

Answer 2

Germ cell

Question 3

Benign testicular tumors are often of what origin?

Answer 3

Sex cord-stromal tumors

Question 4

What is the most common testicular cancer?

Answer 4

Seminoma

Question 5

What is the most common risk factor for developing a testicular cancer?

Answer 5

Cryptorchidism

Question 6

Testicular cancer most often metastasis to what lymph nodes?

Answer 6

Para-aortic

Question 7

Detail the age at which following tumors are commonly seen: seminoma, embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma.

Answer 7

Seminoma- young men and men >65
Embryonal carcinoma- Young men
Choriocarcinoma- Young men
Yolk sac tumor- Children under 4
Teratoma- all ages

Question 8

What age range does the spermatocytic seminoma variant typically occur in?

Answer 8

Older individuals

Question 9

Are most testicular tumors pure or mixed?

Answer 9

Mixed (60%)

Question 10

Of pure testicular tumors, what is the most common type?

Answer 10

Seminoma

Question 11

Describe the biphasic appearance of a seminoma.

Answer 11

Neoplastic cells resemble spermatogonia

Lymphocytic infiltrate

Question 12

Describe the gross appearance of a seminoma.

Answer 12

Fish flesh appearance

Question 13

Compare the chemosensitivity of embryonal carcinoma to teratoma.

Answer 13

Embryonal carcinoma is chemosensitive Teratoma is chemoresistant

Question 14

A teratoma of the testes has squamous cells present, what risk does this confer in terms of prognosis.

Answer 14

Teratomas have the potential to undergo malignant transformation, thus, squamous cells may develop into SCC

Question 15

Cysts are a common feature of what type of testicular tumor?

Answer 15

Teratoma

Question 16

What is the most common testicular tumor in children

Answer 16

Yolk sac tumor

Question 17

What histologic finding is pathognomonic for a yolk sac tuor?

Answer 17

Schiller-Duval bodies

Question 18

What tumor marker indicates a yolk sac tumor?

Answer 18

AFP

Question 19

What tumor marker indicates choriocarcinoma?

Answer 19

hCG

Question 20

What germ cell tumor of the testes has the worst prognosis?

Answer 20

Choriocarcinoma

Question 21

What are the cellular components of a choriocarcinoma?

Answer 21

Syncytiotrophoblast

Cytotrophoblast

Question 22

What testicular cancers can produce gynecomastia?

Answer 22

Choriocarcinoma (hCG is LH analog)

Leydig cell tumor

Question 23

What is the most common testicular caner in men over 60?

Answer 23

Malignant lymphoma

Question 24

Descent of the testes is divided into two phases, the transabdominal phase and the inguinoscrotal phase. What hormones are necessary for each phase?

Answer 24

Transabdominal phase- Mullerian inhibitory hormone

Inguinoscrotal phase- androgen and hCG dependent

Question 25

Define cryptorchidism.

Answer 25

Incomplete or improper descent of the testis into the scrotal sac- most common GU disorder in male children

Question 26

What is the most common site of cryptorchidism?

Answer 26

Inguinal canal

Question 27

Spontaneous descent of cryptorchid testis may occur, at what point in time does spontaneous descent become uncommon?

Answer 27

3 months

Question 28

What complications may arise if an undescended testis is not corrected?

Answer 28

Infertility- testicular atrophy (similar changes can occur in contralateral, normal testis) Increased risk for cancer

Question 29

What are common causes of orchitis?

Answer 29

Mumps Syphilis HIV Extension of acute epidymitis

Question 30

What are common causes of epididymitis in persons under 35?

Answer 30

N. gonorrhoeae | C. trachomatis

Question 31

What are common causes of epididymitis in persons over 35?

Answer 31

E. coli | Pseudomonas aeruginosa

Question 32

Caseating granulomas found in the epididymis are associated with what pathogen?

Answer 32

Tuberculosis

Question 33

What is the most common cause of L sided scrotal enlargement in adults?

Answer 33

Variocele

Question 34

Where does the left spermatic vein drain?

Answer 34

L renal vein

Question 35

Where does the right spermatic vein drain?

Answer 35

Vena cava

Question 36

What diagnostic finding is key to checking for a testicular torsion?

Answer 36

Absent cremasteric sign- stroking inner thigh with tongue blade normally causes scrotum to retract

Question 37

What is the most common causes of scrotal enlargement in children?

Answer 37

Hydrocele