Week 10: Teste Tumors and Hydatidiform Moles

Question 1

What are 2 type of testicular tumors?

Answer 1

Germ Cell Tumor and Stromal Tumor

Question 2

What are 2 type of Germ Cell Tumors?

Answer 2

Seminoma and Nonseminomatous Germ Cell Tumors (NSGCTs)

Question 3

What are 4 type of Nonseminomatous tumors?

Answer 3

• Embryonal Carcinoma
• Yolk Sac Tumor
• Choriocarcinoma
• Teratoma

Question 4

What are 2 type of Stromal Tumors?

Answer 4

• Leydig Cell Tumors
• Sertoli Cell Tumors

Question 5

What is the most common acquired cytogenetic abnormality in germ cell tumors

Answer 5

isochromosome 12q

Question 6

What precursor lesion is found in 90% of GCT

Answer 6

Germ Cell Neoplasia In Situ (GCNIS)

Question 7

caused by an accumulation of serous fluid within the tunica vaginalis of the teste

Answer 7

hydrocele

Question 8

Cryptorchidism (the failure of descent of the testis into the scrotum) is associated with a 3- to 5-fold increased risk for

Answer 8

Testicular Cancer

Question 9

Yolk sac tumors generally produce what hormone in excess?

Answer 9

Alpha-Fetoprotein (AFP)

Question 10

Choriocarcinomas generally produce what hormone in excess

Answer 10

human Chorionic Gonadotropin (hCG)

Question 11

Why is an orchiectomy scheduled without a biopsy for elevated AFP or hCG?

Answer 11

the likelihood is very high that it is a malignant tumor. A biopsy risks spreading tumor cells outside of the testis and preventing surgical cure.

Question 12

ID

Answer 12

Seminoma

In view of the mildly elevated HCG, the normal AFP level, and the homogeneous cut surface of the tumor

Question 13

typically have a heterogeneous appearance with areas of necrosis, cyst formation, and hemorrhage

Answer 13

Nonseminomatous Germ Cell Tumors (NSGCTs)

Question 14

ID

Answer 14

Nonseminomatous Germ Cell Tumors (NSGCTs)

Question 15

the ovarian counterpart of seminoma in the testis

Answer 15

dysgerminoma

Question 16

the Central Nervous System (CNS) counterpart of seminoma in the testis

Answer 16

Germinoma

Question 17

ID

Answer 17

Seminoma

Sheets of uniform polygonal cells (yellow ellipses) divided into ill-defined nodules by fibrous trabeculae (yellow arrow). A lymphocytic infiltrateof activated T cells (cyan arrows) is common

Question 18

ID

Answer 18

Seminoma

Sheets of uniform polygonal cells (yellow ellipses) divided into ill-defined nodules byfibrous trabeculae (yellow arrow). Alymphocytic infiltrateof activated T cells (cyan arrows) is common

Question 19

ID

Answer 19

Choriocarcinoma

Question 20

ID

Answer 20

Choriocarcinoma

choriocarcinomas contain two cell types: syncytiotrophoblasts (curved white arrow) - large, multinucleated cells, produce hCG and cytotrophoblasts (black arrow) - polygonal cells in cords or sheets)

Question 21

Most common primary testicular neoplasm in children younger than 3 years of age; in this age group, it has a very good prognosis

Answer 21

Yolk Sac Tumor

Question 22

ID

Answer 22

Yolk Sac Tumor

Question 23

ID

Answer 23

Yolk Sac Tumor

low cuboidal to columnar epithelial cells that form microcysts (cyan arrow), lacelike (reticular) patterns (yellow ellipse), sheets, glands (cyan circle), and papillae (general look). A distinctive feature is the presence of structures resembling primitive glomeruli, the so-called Schiller-Duval bodies (black arrow). Hyaline globules may also be present.

Question 24

ID

Answer 24

Yolk Sac Tumor

Hyaline globules (black arrows).

Question 25

is most common in men aged 20 to 30. The tumors may be small, even in patients with systemic metastases. It does not express AFP, although most tumors are admixed with other germ cell tumors, including yolk sac tumor (which does express AFP). Only 2%–3% of all testicular germ cell tumors.

Answer 25

Embryonal Carcinoma

Question 26

ID

Answer 26

Embryonal Carcinoma

Question 27

ID

Answer 27

Mature Teratoma

Question 28

ID

Answer 28

Teratoma

Question 29

ID

Answer 29

Teratoma ## Footnote Ectoderm - sebaceous glands (blue curved arrow) Mesoderm - hyaline cartilage (blue arrow) Endoderm - Thyroid colloid (blue open arrow)

Question 30

ID

Answer 30

Leydig Cell Tumors

Question 31

What do Leydig Cell Tumors present with clinically?

Answer 31

may present with gynecomastia or sexual precocity as they may elaborate androgens.

Question 32

What 2 conditions are Leydig Cell Tumors associated with?

Answer 32

* Klinefelter Syndrome (XXY) * Cryptorchidism

Question 33

ID

Answer 33

Leydig Cell Tumor ## Footnote Nucleoli are prominent (black arrows). Approximately 30-40% of tumors have Reinke crystals (cyan and closed black arrow)

Question 34

What is the ploidy of a complete hydatidiform mole?

Answer 34

Diploid

Question 35

Is there a fetus present in a complete hydatidiform?

Answer 35

No fetus present

Question 36

Is there a risk of developing a choriocarcinoma with a complete hydatidiform mole?

Answer 36

Yes; 2.5%

Question 37

What is the ploidy of a partial hydatidiform mole?

Answer 37

Triploid (69, XXY) ## Footnote XXY is most common. Can be XXX or XYY. This is an extra set of all autosomal and sex chromosomes where conditions like Klinefelter is just an additional sex chromosome.

Question 38

Is there a fetus present in a partial hydatidiform?

Answer 38

Fetus present

Question 39

Is there a risk of developing a choriocarcinoma with a partial hydatidiform mole?

Answer 39

Risk is close to 0%

Question 40

ID

Answer 40

Complete Hydatidiform Mole ## Footnote Friable mass of grape-like cystic villi

Question 41

ID

Answer 41

Complete Hydatidiform Mole ## Footnote "Snowstorm" or "Bunch of Grapes" pattern on US

Question 42

ID

Answer 42

Complete Hydatidiform Mole ## Footnote Enlarged and cystic villi with central cisterns and extensive trophoblast proliferation

Question 43

ID

Answer 43

Partial Hydatidiform Mole ## Footnote portion of the villi are grape-like, in a background of more normal (though still friable) placental parenchyma

Question 44

ID

Answer 44

Partial Hydatidiform Mole ## Footnote Scattered cystic villi with less trophoblastic proliferation in a background of normal villi