14.3 Testicular Tumors Flashcards Preview

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Flashcards in 14.3 Testicular Tumors Deck (42):
1

What are the two basic types of testicular tumors?

Germ cell or sex cord stromal

2

What is the classic presentation of testicular tumors?

Firm, painless testicular mass that cannot be transilluminated

3

Why aren't testicular tumors biopsied?

-Risk of seeding scrotum
-Most are malignant anyways

4

What is the general treatment of testicular tumors?

Orchiectomy

5

What is the most common type of testicular tumors? What is the age range that this usually occurs at?

Germ cell tumor
15-40 years old

6

What are the two major risk factors for the development of germ cell tumors?

Cryptorchidism
Klinefelter

7

What are the two types of testicular germ cell tumors?

Seminoma and nonseminoma

8

What is the male equivalent of dysgerminomas?

Seminoma

9

What are the malignant potentials of seminomas and nonseminomas?

Seminomas meta late and respond well to treatment

Non-seminomas met early, and do not respond well to chemo

10

What, generally, are seminomas?

Malignant tumor of large cells with clear cytoplasm, and central nuclei

11

What are the gross characteristics of seminomas?

Homogenous mass without hemorrhage or necrosis

12

What, rarely, may seminomas produce?

beta-HCG

13

Pt presents with a homogenous testicular mass without hemorrhage or necrosis. Histology reveals a malignant tumor of large cells with clear cytoplasm, and central nuclei. Diagnosis?

Seminoma

14

What are embryonal carcinomas?

Malignant tumors of immature, primitive cells that may form glands

15

What are the gross characteristics of embryonal carcinomas?

Hemorrhagic mass with area of necrosis, that may form glands

16

What are the characteristics of embryonal carcinomas, in terms of aggressiveness and spread? How does it met?

Aggressive with early hematogenous spread

17

What might chemotherapy do to an embryonal carcinoma?

May cause it to differentiate into a more mature tumor

18

What are the labs that may be elevated with embryonal carcinomas?

AFP or beta-HCG

19

What is the most common testicular tumor in children?

Yolk sac tumor

20

What are yolk sac tumors?

Malignant tumors that resemble yolk sac elements

21

What is the hormone that is classically elevated in yolk sac tumors?

AFP

22

What are the histological characteristics of yolk sac tumors?

Schiller-Duval bodies--glomerular-like structures

23

Testicular tumor with glomerular-like structures on histology = ?

Schiller-Duval bodies characteristics of yolk sac tumors

24

What are the cells that produce beta-HCG in the developing fetus?

Syncytiotrophoblasts

25

What are the metastatic characteristics of choriocarcinomas? Why?

Spread early hematogenously--placental tissue is programmed to find blood vessels

26

What is the hormone that can be produced by choriocarcinomas? What, then, are the s/sx that result?

beta-HCG

Hyperthyroidism or gynecomastia

27

Why is is that high levels of beta-HCG from yolk sac tumors may cause hyperthyroidism?

Beta subunit of HCG is similar to TSH and FSH/LH

28

What are the cell types that comprised choriocarcinomas?

Syncytiotrophoblasts
Cytotrophoblasts (NOT vili)

29

What is the usual paradigm that helps determine primary vs secondary tumors? What is odd about this with choriocarcinomas of the testicle?

Primary is usually larger than mets, but this is reversed with choriocarcinomas

30

What is the difference between teratomas in males vs females

Males = malignant
Females =benign

31

What are the hormones that teratomas may produce?

beta HCG or AFP

32

True or false: most germ cell tumors are mixed germ cells

True

33

What is the prognosis of mixed germ cell tumors based on?

Worst component

34

What are the cells that line the seminiferous tubules?

Sertoli cells

35

What are sex-cord stromal tumors of the testicle? Are they usually benign or malignant?

Tumors that resemble sex cord stroma of the testicle

Usually benign

36

What are the pink cells that surround sertoli cells?

Leydig cells

37

Leydig cell tumors usually produce what hormone? What, then, are the s/sx of these tumors?

Usually produce androgen

Precocious puberty in children, or gynecomastia in adults

38

What are the classic histological characteristics of Leydig cell tumors?

Reinke crystals

39

Reinke crystals = ?

Leydig cell tumors

40

What are sertoli cell tumors comprised of? What are the classic clinical s/sx of sertoli cells?

Comprised of tubules
Usually clinically silent

41

What is the most common cause of a testicular mass in a male over the age of 60? Are these usually unilateral or bilateral?

Lymphoma
BIlateral

42

What type of lymphoma usually mets to the testicles?

Diffuse, large B cell lymphoma