227- groin disease Flashcards
what is a hydrocele? A spermatocele? an epididymal cyst?
fluid b/w parietal and visceral layers of tunica vaginalis.
seminal fluid-filled mass eminating from rete teste
Clear fluid cyst projecting from epidydimis
All three transilluminate
most common cause of testicular torsion in post-pubertal males
abnormally high investment of tunica vaginalis on spermatic cord
what age group gets testicular cancer? what do the others get?
20-40
Men over 50 get lymphoma
Molecular pathogenesis of testicular CA
isochromosome of short arm of 12. [i(12p)] chromosomal marker. Encodes cyclin D.
What do people with cryptorchidism have increased rates of?
testicular cancer and testicular torsion
what can prevent penile cancers
NEONATAL circumcision
difference b/w erythroplasia of querat and bowen’s disease
first is on glans or prepuce. Second is on shaft or surrounding soft tissue.
boundaries of femoral triangle
inguinal ligament, sartorius, adductor longus. Fascia lata separates deep from superficial nodes
order of things coming thru femoral triangle
NAVeL
what percent of solid testicular masses are malignant
almost all
Tumor markers for testicular CA
hCG (comes from syncitiotrophoblast) is seen in seminomas and non-seminomas
AFP is NEVER elevated in pure seminomas
what do you do following orchiectomy
redo serum markers. If they are still elevated you know there is mets and you treat with systemic chemo
why do we do orchiectomy inguinally and not thru scrotum
permits removal of in-transit CA in the spermatic cord. Avoids contaminating the scrotal lymphatics, which are not usually involved.
where do the testes lymph drain
right side to interaortocaval nodes. Left side to para-aortic nodes
Three possible management strategies of seminoma
observation, radiation, chemo (PEB)
