Testis, Scrotal Sac, and Epididymis Diseases Flashcards

1
Q

Testicular tumors are most often of what origin?

A

Germ cell

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2
Q

Malignant testicular tumors are often of what origin?

A

Germ cell

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3
Q

Benign testicular tumors are often of what origin?

A

Sex cord-stromal tumors

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4
Q

What is the most common testicular cancer?

A

Seminoma

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5
Q

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

A

Cryptorchidism

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6
Q

Testicular cancer most often metastasis to what lymph nodes?

A

Para-aortic

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7
Q

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

A
Seminoma- young men and men >65
Embryonal carcinoma- Young men
Choriocarcinoma- Young men
Yolk sac tumor- Children under 4
Teratoma- all ages
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8
Q

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

A

Older individuals

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9
Q

Are most testicular tumors pure or mixed?

A

Mixed (60%)

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10
Q

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

A

Seminoma

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11
Q

Describe the biphasic appearance of a seminoma.

A

Neoplastic cells resemble spermatogonia

Lymphocytic infiltrate

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12
Q

Describe the gross appearance of a seminoma.

A

Fish flesh appearance

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13
Q

Compare the chemosensitivity of embryonal carcinoma to teratoma.

A

Embryonal carcinoma is chemosensitive Teratoma is chemoresistant

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14
Q

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

A

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

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15
Q

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

A

Teratoma

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16
Q

What is the most common testicular tumor in children

A

Yolk sac tumor

17
Q

What histologic finding is pathognomonic for a yolk sac tuor?

A

Schiller-Duval bodies

18
Q

What tumor marker indicates a yolk sac tumor?

A

AFP

19
Q

What tumor marker indicates choriocarcinoma?

A

hCG

20
Q

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

A

Choriocarcinoma

21
Q

What are the cellular components of a choriocarcinoma?

A

Syncytiotrophoblast

Cytotrophoblast

22
Q

What testicular cancers can produce gynecomastia?

A

Choriocarcinoma (hCG is LH analog)

Leydig cell tumor

23
Q

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

A

Malignant lymphoma

24
Q

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

A

Transabdominal phase- Mullerian inhibitory hormone

Inguinoscrotal phase- androgen and hCG dependent

25
Q

Define cryptorchidism.

A

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

26
Q

What is the most common site of cryptorchidism?

A

Inguinal canal

27
Q

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

A

3 months

28
Q

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

A

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

29
Q

What are common causes of orchitis?

A

Mumps
Syphilis
HIV
Extension of acute epidymitis

30
Q

What are common causes of epididymitis in persons under 35?

A

N. gonorrhoeae

C. trachomatis

31
Q

What are common causes of epididymitis in persons over 35?

A

E. coli

Pseudomonas aeruginosa

32
Q

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

A

Tuberculosis

33
Q

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

A

Variocele

34
Q

Where does the left spermatic vein drain?

A

L renal vein

35
Q

Where does the right spermatic vein drain?

A

Vena cava

36
Q

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

A

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

37
Q

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

A

Hydrocele