Pathology: Male Genital Tract

Question 1

Most squamous carcinoma of the penis are invasive

True or false?

Answer 1

False

Around 5% are

Question 2

Which type of men are most at risk of squamous carcinoma of the penis?

Answer 2

Uncircumcised

Question 3

Which aetiological factors predispose to squamous carcinoma of the penis?

Answer 3

Poor hygiene

No circumcision

HPV

Question 4

What is the appearance of a squamous carcinoma of the penis?

Answer 4

Ulcerating indurated tumour or exophytic mass

Question 5

Which age group are affected by benign nodular hyperplasia of the prostate?

Answer 5

70

(75% over this age affected, 5% symptomatic)

Question 6

In benign nodular hyperplasia of the prostate there is irregular proliferation of which tissues?

Answer 6

Glandular and stromal prostatic tissue

Question 7

What is thought to cause benign nodular hyperplasia of the prostate?

Answer 7

Hormonal imbalance

Alteration of Androgen/Oestrogen ratio

(Central (peri-urethral) gland involved – oestrogen responsive)

Question 8

Prostatism refers to which clinical symptoms?

Answer 8

Difficulty in starting micturition, poor stream, overflow incontinence.

Question 9

What are the complications of BPH?

Answer 9

Bladder hypertrophy, diverticulum formation

If untreated hydroureter, hydronephrosis, infection can occur

(it is not a pre-malignant condition)

Question 10

How is BPH treated?

Answer 10

Surgery (transurethral resection)

Drugs (alpha blockers, 5 alpha reductase inhibitors)

Question 11

Carcinoma of the prostate is the _______ leading cause of cancer in males

Answer 11

Carcinoma of the prostate is the second leading cause of cancer in males

Question 12

What is the peak incidence for cacinoma of the prostate?

Answer 12

60-80

(rare before 50)

Question 13

Carcinoma of the prostate is releated to BPH

True or false?

Answer 13

False

Question 14

Where does carcinoma of the prostate mainly arise from?

Answer 14

Peripheral ducts and glands

(particularly posterior lobe)

The peri-urethral zone is involved at a later stage

Question 15

What are the local areas to which carcinoma of the prostate can spread?

Answer 15

Urethral (obstruction)

Capsular penetration

Seminal vesicles

Bladder

Rectum

Question 16

How does carcinoma of the prostate affect the bone when it metastasizes?

Answer 16

Osteosclerosis

(bone growth)

Question 17

Which lymph nodes are most affected by carcinoma of the prostate?

Answer 17

Sacral

Ilial

Para-aortic

Question 18

In which ways can carcinoma of the prostate be diagnosed?

Answer 18

Rectal exam

USS/skeletal X-rays/bone scans

Increased PSA

Biopsy (multiple biopsies)

Question 19

How is carcinoma of the prostate managed?

Answer 19

Hormonal Therapy – anti-androgen treatment

Radiotherapy – bone metastases

Surgery – Radical Prostatectomy

Question 20

How common are testicular tumours?

Answer 20

1% cancer deaths in males

Most common organ malignancy in young males

Question 21

Which risk factor for testicular tumour insreases risk 10 fold?

Answer 21

Testicular maldescent

Question 22

How do testicular tumours present?

Answer 22

Painless testicular enlargement

Question 23

Testicular tumours can be associated with which other signs/conditions?

Answer 23

Hydrocele

Gynaecomastia

General effects of malignant disease

Question 24

What are the different type of testicualr tumours?

Answer 24

Germ cell tumours

Paratesticular tumours

Others

Question 25

What is the most common type of tumour?

Answer 25

Germ cell | (seminoma, teratoma)

Question 26

What is the most common type of germ cell tumour?

Answer 26

Seminoma

Question 27

What is the peak age of incidence for seminomas?

Answer 27

30-50

Question 28

How does a seminoma appear?

Answer 28

Solid, homogenous, pale and macroscopic | (like a potato)

Question 29

Where do seminomas spread lymphatically?

Answer 29

Para-aortic lymph nodes

Question 30

Where do seminomas often metastasize?

Answer 30

Lungs Liver Brain

Question 31

What is the management and prognosis for seminoma?

Answer 31

Radiotherapy or chemotherapy Very good (\>95% cure rate)

Question 32

Which type of tumour are teratomas?

Answer 32

Germ cell

Question 33

What si the peak incidence for teratomas?

Answer 33

20-30 (can be see in childhood unlike seminomas)

Question 34

What is the appearance of teratomas?

Answer 34

Solid areas Cysts Haemorrhage Necrosis

Question 35

Very cystic tumours of the testes are more liekly to be what?

Answer 35

Benign

Question 36

Tertaomas may involve tissues from whcih embryological origin?

Answer 36

Ectoderm, mesoderm or endoderm | (any tissue can develop)

Question 37

What is the most danagerous type of teratoma?

Answer 37

Trophoblastoma | (resembles placenta)

Question 38

Tropholastic teratomas can be monitors by which marker?

Answer 38

bHCG

Question 39

Seminoma will secrete which marker?

Answer 39

PLAP

Question 40

What are the main uses for tumour markers from the testes?

Answer 40

Diagnosis Response to therapy Early recurrence