10. Testicular Cancer

Question 1

Risk factor for Testicular Cancer

Answer 1

1. Cryptorchidism (for both testicles
2. Gonadal Dysgenesis
3. Klinefelters
4. Trauma
5. Orchitis
6. Testicular microlithiasis

Question 2

MAle + 18-35 + Undescended testicle =

Answer 2

Seminoma

Question 3

Nonpalpable testicle =

Answer 3

undescended testicle

Question 4

Subtypes of TEsticular Cancer

Answer 4

1. Germ Cell (90%)
   a. Seminoma
   b. Non Seminoma
   - Teratoma
   - Yolk Sac
   - Mixed germ Cell
2. Non germ Cell (10%)
   
   • Sertoli
   • Leydig

Question 5

Most testicular tumors met via Via the lymphatics (retroperitoneal at the renal hilum) EXCEPT

Answer 5

Choriocarcinoma (Hematogeneous)

Question 6

Mass in the ball sac + Intratesticular + Solid =

Answer 6

Likely Malignant

Question 7

Mass in the ball sac + Intratesticular + Cystic =

Answer 7

Likely Benign

Question 8

Mass in the ball sac + Extratesticular + Cystic =

Answer 8

Benign

Question 9

his is the most common testicular tumor, and has the best prognosis as they are very radiosensitive

Answer 9

Seminoma

Question 10

Age 25 + mass in ballsac + homogeneous hypoechoic round + Microcalcifications - “replaces” the entire testicle + Dark T2 =

Answer 10

Seminoma

Question 11

Mass in ballsac + Heterogeneous + cystic spaces and calcification +

Answer 11

Non-Seminomatous Germ Cell Tumor

Question 12

Heterogeneous mass —> shrinks + calcifications =

Answer 12

Buned-out Testicular tumor (Shrinking tumor)

Question 13

Unilateral + Diffusely large ill-defined testicle / Multiple hypoechoic masses + 60 y.o. + Immunosuppresed + =

Answer 13

Testicular Lymphoma (CAn be bilateral

Question 14

Most common bilateral testicular tumor =

Answer 14

Testicular Lymphoma

Although it is usually unilateral (60%)

Question 15

Testicular lymphoma is usually this subtype =

Answer 15

Diffuse B-Cell

Question 16

Homogenous and Microcalcifications =

Answer 16

Seminoma

Question 17

Cystic Elements and Macrocalcifications =

Answer 17

Mixed Germ Cell Tumor / Teratoma

Question 18

Most testicular tumors met via =

Answer 18

the lymphatics to the retroperitoneal nodes

Question 19

Gynecomastia can be seen with

Answer 19

Sertoli Leydig Tumors

Question 20

Peutz-Jeghers Syndrome can be seen with

Answer 20

Sertoli Tumors

Question 21

Bilateral testicular cancer =

Answer 21

Lymphoma

Question 22

Bilateral hypoechoic masses =

Answer 22

Lymphoma

Question 23

Bilateral solid testicular masses + congenital adrenal hyperplasia =

Answer 23

Adrenal Rests

Question 24

Bilateral solid testicular & epididvmal masses =

Answer 24

Testicular Sarcoid

Question 25

Bilateral 1-6-mm, hyperechoic, avascular masses + Cowden Syndrome =

Answer 25

Focal Lipomatosis

Question 26

Elevated Beta hCG

Answer 26

Seminoma Choriocarcinoma (Non-Seminoma)

Question 27

Elevated AFP

Answer 27

Mixed Germ Cell (Non-S) Yolk Sac (Non-S)

Question 28

Male age 18-35, pelvic mass with an ipsilateral draining vein that empties into the inferior vena cava (if right sided) or left renal vein (if left sided) = + scrotum with only one testicle

Answer 28

Think of Cancer of the undescended testicle - whisper "nice try assholes"

Question 29

Lung probles + Uveitis + Multiple small hypoechoic testicle lesions that don’t change over time =

Answer 29

Sarcoid of the balls

Question 30

Testicular mets should spread to

Answer 30

Para-aortic Aortic Caval region N1-N3

Question 31

Non regional metastasis =

Answer 31

Mets to the pelvic, external iliac and inguinal nodes (M1 disease)

Question 32

Pain + No trauma + No blood flow =

Answer 32

Infarct

Question 33

History of Acute pain + No increased internal flow on Dopper wihtin the masses

Answer 33

Hematoma

Question 34

Answer 34

Epidermoid Cyst "Onion skin" alternating hypoechoic and hyperechoic rings Relatively non-vascular - benign

Question 35

Answer 35

Tubular ectasia of teh Rete Testis Cystic dilatation next to the mediastinum testis - normal variant From obliteration (complete or partial) of the efferent ducts.