14.3 Testicular Tumors

Question 1

Testicular tumors arise from what 2 tissues

Answer 1

germ cell

sex cord-stroma

Question 2

how do Testicular tumors differ in presentation from hydrocele

Answer 2

can’t be transilluminated

Question 3

What are most Testicular tumors not biopsied? (2)

Answer 3

risk of seeding the scrotum

>95% are malignant

Question 4

what is tx for Testicular tumors

Answer 4

removal via radical orchiectomy

Question 5

what is MC type of testicular tumorq

Answer 5

germ cell (>95%)

Question 6

what age range do germ cell tumors usually occur

Answer 6

15-40

Question 7

2 risk factors for germ cell tumors

Answer 7

cryptochordsim

Klinfelters

Question 8

2 classifications of germ cell tumors and which is MC

Answer 8

seminoma - MC (55%)

nonseminomas (45%)

Question 9

Seminomas: respnse to radiation, metastasize early or late, px?

Answer 9

excellent response to radiation
metastasize late
excellent px

Question 10

Nonseminomas: respnse to radiation, metastasize early or late, px?

Answer 10

variable response to radiation
metastasize early
px?

Question 11

3 chcs of seminoma on histo

Answer 11

large cell
clear cytoplasm
central nuclei

Question 12

3 chc of seminoma tumor (HY)

Answer 12

homogenous mass
no hemorrhage
no necrosis

Question 13

seminoma resembles what in ovary

Answer 13

dysgerminoma

Question 14

rare seminoma may produce what

Answer 14

B-hCG

Question 15

What do the cells in a embryonal carcinoma look like (2)

Answer 15

immature primitive

Question 16

what might an embryonal carcinoma produce structurally

Answer 16

glands

Question 17

why is embryonal carcinoma so aggresive and how does it spread

Answer 17

spreads hemtogenously and is aggressive because the embryonal cells are programmed to spread

Question 18

What effect does CXT (chemothx) have on embryonal carcinoma (HY)

Answer 18

it cuases differentiation into teratoma or another type of germ cell tumopr

Question 19

What two markers does embryonal carcinoma release

Answer 19

AFP, B-hCG (alpha fetoprotein)

Question 20

what is MC testicular tumor in kids

Answer 20

yolk-sac (endodermal sinus tumor)

Question 21

What marker is elevated in yolk-sac tumor

Answer 21

AFP

Question 22

What is chc histo finding in yolk-sac tumor

Answer 22

Schiller-Duvall bodies (glomeruloid structure)

Question 23

choriocarcinoma is malignant tumor of what 2 cells

Answer 23

syncytiotrophoblasts

cytotrophoblasts

Question 24

how does choriocarcinoma spread

Answer 24

via blood

Question 25

what is elevated in choriocarcinoma

Answer 25

B-hCG

Question 26

What other condition may be seen in choriocarcinoma and why (HY)

Answer 26

hyperthyroidism may be seen becuase the alpha-subunit of hCG resembles thyroid homos (LH, FSH, TSH)

Question 27

Benign or malignant: teratoma in females, in males (HY)

Answer 27

in males = malignant | in females = benign

Question 28

what 2 markers may be increased in teratoma

Answer 28

B-hCG | AFP

Question 29

in mixed germ cell tumors which tumor decides px?

Answer 29

the worst px

Question 30

what are the two cells involved in sex-cord stromal tumors in males

Answer 30

sertoli | leydig

Question 31

What is clinical presetation of Sertoli cell tumor

Answer 31

clinically silent

Question 32

which cell forms the tubules and which is in interstitium- sertoli and leydig

Answer 32

``` sertoli = tubules Leydig = interstitium ```

Question 33

what homo does leydig cell tumor produce

Answer 33

androgen

Question 34

CHC hallmark of Leydig cell tumor on histo (HY)

Answer 34

Reinke Crystals

Question 35

2 sequlae of leydg cell tumor

Answer 35

gynecomastia | precocious puberty

Question 36

Germ cell tumor is MC cz of mass 15-40. What is MC testicular mass in >60 males? uni- or bilateral presentation?

Answer 36

lymphoma - often bilateral

Question 37

What lymphoma type is usually seen in testicular masses

Answer 37

diffuse B-cell type