Tumors of the male reproductive system

Question 1

Canine testicular tumor are most common in what location?

___ % tumor of all male reproductive tract

Answer 1

male genitalia

90%

Question 2

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

Answer 2

Testis

Question 3

What is the prevelance of canine testicular tumors?

Answer 3

prevalence 6-27%

Question 4

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

Answer 4

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

Develop with equal frequency

Question 5

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.

Question 6

What 2 tumors occur with higher frequenct in cyrptorchid testes?

Answer 6

Sertoli cell tumors and seminomas

Question 7

_____% more than one type of testicular tumor

Answer 7

4-20%

Question 8

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

Answer 8

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

Question 9

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

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

Answer 9

12. 7
13. 1

Question 10

What type or cryptorchidism increases the risk?

Answer 10

Inguinal cryptorchidism increases the risk compared w/ abdominal cryptorchidism

Question 11

What 3 drugs can increase the development of testicular tumors?

Answer 11

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

Question 12

Where do sertoli cell tumors originate from?

Answer 12

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

Question 13

What cell type gives rise to seminoma’s?

Answer 13

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

Question 14

What cell type gives rise to interstitial cell tumor?

Answer 14

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

Question 15

Aggressive testicular tumors can express what 4 molecules?

Answer 15

TERT, p53, PCNA, and Ki67

Question 16

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

Answer 16

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

Question 18

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

Answer 18

VEGF, MVD (microvessel density)

Question 19

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

Answer 19

KIT

Question 20

How do canine testicular tumors behave?

Answer 20

local invasion and rarely metastasize

Question 21

Sertoli cell tumor cause _____, ____% estrogen overproduction

Answer 21

feminization, >50%

Question 22

Clinical signs seen with sertoli cell tumor?

Answer 22

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.

Question 23

____% scrotal Sertoli cell tumors developed feminization

Answer 23

17%

Question 24

History and clinical sign associated with canine testicular tumors?

Answer 24

most are asymptomatic, discovered as an incidental finding

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

Question 25

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

Answer 25

hyperestrogenism

Question 26

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

Answer 26

BM suppression

Question 27

What is the treatment of choice for canine testicular tumor?

Answer 27

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

Question 28

\_\_\_\_ is the treatment of choice for testicular tumors given that up to ___ % bilateral tumors and only \_\_\_% are clinically detectable in the contralateral testicle.

Answer 28

Bilateral orchiectomy 50%, 12%

Question 29

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

Answer 29

1-3 months metastatic estrogen

Question 30

Recurrence of feminization following castration may be associated with \_\_\_\_

Answer 30

the presence of metastasis

Question 31

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

Answer 31

5 ~ \>31 months

Question 32

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

Question 33

Feline Testicular Tumors * rare and biologic behavior is unclear * optimal therapy other than orchiectomy is not known

Question 34

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

Question 35

How common are canine prostatic tumors?

Answer 35

relatively uncommon - \< 1%

Question 36

\_\_\_\_\_% prostatic disease were prostate carcinoma (PCA) Age of dogs diagnosed? What are the 2 types of carcinomas?

Answer 36

7-16% elderly dogs are more commonly diagnosed w/ PCA most are carcinoma (TCC or adenocarcinoma)

Question 37

Most canine prostatic carcinoma have what origin?

Answer 37

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

Question 38

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

Answer 38

castrated male dogs castrated males

Question 39

What is the behaivour of canine prostate tumors?

Answer 39

local invasion w/ a high propensity for distant mets

Question 40

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

Answer 40

bone, 22-42%

Question 41

\_\_\_\_ dogs w/ PCA may increase risk for mets than \_\_\_\_\_dogs

Answer 41

Younger, older

Question 42

high-grade prostatic intraepithelial neoplasia (HGPIN) is considered a precursor of human PCA ## Footnote HGPIN as a predictor may not be as reliable in dogs as it is in men

Question 43

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

Answer 43

BRAF, MAPK similar b/w PCA and TCC

Question 44

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

Answer 44

COX-2, 75%

Question 45

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

Answer 45

TGF-β, PTHrP, and endothelin

Question 46

Common clinical signs include?

Answer 46

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

Question 47

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.

Question 48

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

Answer 48

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

Question 49

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

Answer 49

False, they are likely to have neoplasia

Question 50

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

Question 51

MSTs for dog w/o therapy with PCA is?

Answer 51

\< 30 days

Question 52

\_\_\_\_\_ 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.

Answer 52

Prostatectomy Total prostatectomy

Question 53

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

Question 54

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

Answer 54

231 days

Question 55

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

Answer 55

10%

Question 56

Stents for PCA considered as palliative and complications include?

Answer 56

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

Question 57

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

Question 58

The benefit of systemic therapy to manage canine PCA is unclear treated w/ piroxicam or carprofen (\_\_\_\_ mo) vs. untreated (\_\_ mo)

Answer 58

6.9mon, 0.7 mon