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Tumors of the male reproductive system Flashcards

1
Q

Canine testicular tumor are most common in what location?

___ % tumor of all male reproductive tract

A

male genitalia

90%

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2
Q

What location is the 2nd most common anatomic site for tumor development:

A

Testis

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3
Q

What is the prevelance of canine testicular tumors?

A

prevalence 6-27%

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4
Q

What are the 3 most common testicular tumors and cell of origin?

A

Sertoli cell tumor (sustentacular cells of Sertoli), seminoma (spermatic germinal epithelium) and interstitial cell tumor (interstitial cells of Leydig)

Develop with equal frequency

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5
Q

WHO classification of tumor of domestic animal: sex-cord stromal tumor (Sertoli cell tumor and interstitial cell tumor), germinal tumor (seminoma, teratoma) and mixed germ cell-sex-cord stromal tumors.

A
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6
Q

What 2 tumors occur with higher frequenct in cyrptorchid testes?

A

Sertoli cell tumors and seminomas

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7
Q

_____% more than one type of testicular tumor

A

4-20%

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8
Q

There is significant association b/w cryptorchidism and what 2 tumor types?

A

Development of Sertoli cell tumor and seminomas, but not interstitial cell tumors

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9
Q

Incidence of testicular tumor in cryptorchid dog was ___ per 1000 dog-years

Cryptorchid dog older than 6 years – increased to ____ per 1000 dog-years

A
  1. 7
  2. 1
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10
Q

What type or cryptorchidism increases the risk?

A

Inguinal cryptorchidism increases the risk compared w/ abdominal cryptorchidism

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11
Q

What 3 drugs can increase the development of testicular tumors?

A

phenoxy herbicide, dioxin or tetracycline may promote the development of testicular tumors

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12
Q

Where do sertoli cell tumors originate from?

A

Sustentacular cells of seminiferous tubules – firm, lobulated, white-to-gray, “greasy”

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13
Q

What cell type gives rise to seminoma’s?

A

Germinal epithelium of seminiferous tubules – homogenous, soft, and occasionally lobulated with ivory appearance when sectioned.

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14
Q

What cell type gives rise to interstitial cell tumor?

A

Leydig cells located b/w seminiferous tubules – soft, expansive, yellow-to-orange when sectioned, often cysts w/ serous or serosanguineous fluid

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15
Q

Aggressive testicular tumors can express what 4 molecules?

A

TERT, p53, PCNA, and Ki67

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16
Q

Mutations of the ___ gene are a common genetic alteration in both human and canine malignancies, and increased ____ has been associated with tumor progression

A

p53 tumor suppressor

p53 expression

expression intensity was stronger in diffuse type Sertoli cell tumors and seminomas

p53 may be an indicator of tumor aggression, however, further studies should be needed

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17
Q
A
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18
Q

____ expression and _____ were higher in seminomas compared to normal testes in one study

A

VEGF, MVD (microvessel density)

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19
Q

The ____ protein may be essential to the development, proliferation, and maturation of germ cells

canine seminomas appeared to be differentiated into classic (SE) and spermatocytic seminoma (SS) on the basis of KIT and PLAP (placental alkaline phosphatase) staining

similar w/ human, SE should express both and SS should be negative

A

KIT

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20
Q

How do canine testicular tumors behave?

A

local invasion and rarely metastasize

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21
Q

Sertoli cell tumor cause _____, ____% estrogen overproduction

A

feminization, >50%

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22
Q

Clinical signs seen with sertoli cell tumor?

A

bilateral symmetric alopecia, cutaneous hyperpigmentation, epidermal thinning, squamous metaplasia of the prostatic epithelium, gynecomastia, galactorrhea, attraction of other males, preputial atrophy, atrophy of the nonneoplastic testicle, and bone marrow suppression.

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23
Q

____% scrotal Sertoli cell tumors developed feminization

A

17%

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24
Q

History and clinical sign associated with canine testicular tumors?

A

most are asymptomatic, discovered as an incidental finding

palpation of an enlarged testicle or a testicular mass during routine physical examination

25
Q

Clinical signs associated with canine testicular tumors may be attributable to paraneoplastic syndromes such as?

A

hyperestrogenism

26
Q

The most deleterious effect of hyperestrogenism is _____, which may be irreversible and life threatening

A

BM suppression

27
Q

What is the treatment of choice for canine testicular tumor?

A

orchiectomy with scrotal ablation is the treatment of choice and is often curative

28
Q

____ is the treatment of choice for testicular tumors

given that up to ___ % bilateral tumors and only ___% are clinically detectable in the contralateral testicle.

A

Bilateral orchiectomy

50%, 12%

29
Q

clinical signs of hyperestrogenism typically resolve within ____ following castration, unless ____ lesions provide persistent ____ release

A

1-3 months

metastatic

estrogen

30
Q

Recurrence of feminization following castration may be associated with ____

A

the presence of metastasis

31
Q

Cisplatin was evaluated in 3 dogs with aggressive testicular tumors, with survival ranging from ___?

A

5 ~ >31 months

32
Q

RT was successfully used in 4 dogs with metastatic seminoma confined to the regional LNs using total doses ranging from 17 to 40 Gy with Cesium-137 teletherapy

ST 6 to 37 months, none of dogs died of seminoma

seminomas are considered extremely radioresponsive

A
33
Q

Feline Testicular Tumors

  • rare and biologic behavior is unclear
  • optimal therapy other than orchiectomy is not known
A
34
Q

Comparative Aspects

In US, testicular cancer is the most common cancer in men 15-44 yo

most in men are germ cell tumor (50% pure seminomas and 50% non-seminomas)

Seminomas are further classified into classical (SE), atypical, or spermatocytic seminoma (SS)

Treatment generally includes surgery for stage I seminomas, and/or RT and chemotherapy for advanced stage disease.

Cisplatin-based chemotherapy protocols for patients with greater than stage I disease

70- 80% cure rates

A
35
Q

How common are canine prostatic tumors?

A

relatively uncommon - < 1%

36
Q

_____% prostatic disease were prostate carcinoma (PCA)

Age of dogs diagnosed?

What are the 2 types of carcinomas?

A

7-16%

elderly dogs are more commonly diagnosed w/ PCA

most are carcinoma (TCC or adenocarcinoma)

37
Q

Most canine prostatic carcinoma have what origin?

A

likely have a urethelial or ductular origin rather than acinar – b/c most androgen independent

38
Q

Risk Factors for canine prostatic tumors

  • there is an increased risk of PCA in _____ compared w/ intact – odd ratio 2.3-4.3
  • more aggressive tumor may develop in ______ w/ higher mets
A

castrated male dogs

castrated males

39
Q

What is the behaivour of canine prostate tumors?

A

local invasion w/ a high propensity for distant mets

40
Q

similar to high-grade PCA in men, canine PCA has tendency to metastasize to ___ – ____%

A

bone, 22-42%

41
Q

____ dogs w/ PCA may increase risk for mets than _____dogs

A

Younger, older

42
Q

high-grade prostatic intraepithelial neoplasia (HGPIN) is considered a precursor of human PCA

HGPIN as a predictor may not be as reliable in dogs as it is in men

A
43
Q

activating mutations in _____ gene, which lead to constitutive _____ signaling, were found in the majority of PCA in dogs

mutation frequency?

A

BRAF, MAPK

similar b/w PCA and TCC

44
Q

_____ expression may play a role in carcinogenesis and progression in PCA – was noted _____% of PCA

A

COX-2, 75%

45
Q

PCA has a predilection for bone, which may be mediated in part by what 3 factors?

A

TGF-β, PTHrP, and endothelin

46
Q

Common clinical signs include?

A

hematuria, dysuria, stranguria, dyschezia, tenesmus, bacteriuria, and altered stool shape (flattened or ribbonlike stools)

47
Q

PCA

complete obstruction of urinary outflow results from prostatic compression or direct tumor extension into the urethra, hydroureter, hydronephrosis, and renal failure may occur

local invasion into the lumbar vertebrae or nerve roots may cause pain, gait abnormalities, lameness, and/or constipation

skeletal metastasis may present with signs of severe bone pain, pathologic fracture, or rarely with a palpable mass.

A
48
Q

The presence of mineralization, particularly in intact dogs, is pathognomonic for neoplasia, T/F?

Differentials?

A

the presence of mineralization, particularly in intact dogs, is not pathognomonic for neoplasia and can occur in dogs with prostatitis, BPH, or prostatic cysts

49
Q

Neutered dogs with prostatic mineralization are unlikely to have prostatic neoplasia and should undergo further diagnostics, T/F

A

False, they are likely to have neoplasia

50
Q

Gleason-type grading system may provide some level of prognostication in dogs and to better correlate finding to PCA in men

A
51
Q

MSTs for dog w/o therapy with PCA is?

A

< 30 days

52
Q

_____ is generally recommended for dogs with early stage and intracapsular disease

____ can be performed, although it is associated with a high rate of postoperative morbidity and a survival benefit has not been definitively demonstrated.

A

Prostatectomy

Total prostatectomy

53
Q

the most common complication is urinary incontinence, occurring 33-35%

A
54
Q

MST for 25 dogs which performed total prostatectomy was ____d; intracapsular tumor had significantly longer MST than extracapsular (248 d vs. 138 d), 30% suspected local recurrence and/or distant mets

A

231 days

55
Q

For PCS- stents are recommended to be ___% greater than the diameter of healthy appearing urethra

A

10%

56
Q

Stents for PCA considered as palliative and complications include?

A

incontinence (severe in 25%), stranguria, reobstruction, and stent migration

57
Q

RT may be useful in palliation of clinical signs related to local PCA and to painful skeletal mets

intraoperative orthovoltage therapy in 9 dogs (20-30 Gy), MST-114 days

local dz should be better targeted and controlled by advanced RT plan (3DCRT, IMRT, IGRT)

definitive IM/IGRT in 21 dogs (54-58 Gy) – median event-free ST was 317 d (10 PCA dogs) and overall MST 654 d

A
58
Q

The benefit of systemic therapy to manage canine PCA is unclear

treated w/ piroxicam or carprofen (____ mo) vs. untreated (__ mo)

A

6.9mon, 0.7 mon

59
Q
A

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