Scrotum Flashcards

1
Q

Externally, _________ divides into two compartments

A

The Raphe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Internally what merges centrally to form the internal scrotal septum?

A

Dartos tunica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Internally (scrotal), _________ merges centrally to form internal scrotal septum

A

Dartos Tunica

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the thickness of scrotal wall?

A

2-8 mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the scrotum lined by?

A

Tunica vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many layers of tunica vaginalis? What are they?

A

Two layers
1. Parietal
2. Visceral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How much fluid is between each layer o the tunica vaginalis?

A

1-2 ml of fluid between layers normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is a pouch of loose skin and fascia?

A

Scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the scrotum contain? 4

A
  1. Testicles
  2. Epididymis
  3. Vas deferents
  4. Spermatic cord
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does the testicles produce?

A

Sperm and testosterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the shape of the testicles? What is the dimensions?

A

Oval shape

Length: 3-5cm
Width: 2-4 cm
AP: 3cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Does the testicles decrease in size? Why?

A

They decrease with advance age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the tunica albuginea? What does it form?

A
  1. Fibrous layer surrounding testes
  2. Form the mediastinum posteriorly
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Invaginations of the tunica albuginea divide the testicles into what?

A

Lobules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What does each lobule contain? What are they the site for?

A
  1. Seminiferous tubule
  2. Spermatogenesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the mediastinum formed by?

A

The converging of the thin septations of the tunica albugenea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Where is the mediastinum functions?

A

Forms and supports for testicular vessels and ducts from extending from testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Where is the mediastinum located?

A

Posterior testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Where does the rete testes converge? Where do they join to form?

A
  1. Converging of seminiferous tubules at the mediastinum
  2. Join to form efferent ducts
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What does Rete testes carry?

A

Seminal fluid to the epididymis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the bare area?

A

Testes tethered to scrotal wall by visceral layer of the tunica vaginalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where is the point of attachment for the bare are?

A

Posterior

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What area is not covered by peritoneum and is a small portion of the posterior testis and epididymis?

A

Bare area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is a appendix testes? Does it have a function? Where is it located?

A
  1. Remnant of the Müllerian duct; no function
  2. Upper pole of the testes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the epididymis shaped like?

A

Comma shaped structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Where is the head and the body of the epididymis located?

A

Head: superior
Body: Posterolateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What does the tail of the epididymus empties into?

A

Vas Deferens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How long is the epididymus?

A

6-7 cm length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the epididymus formed by?

A

The convergence of the efferent ducts from rete testes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the dimensions of the head of the epididymus?

A

Head: 10-12mm
Body: 2-4mm
AP: 2-5mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is another name of the head of the epididymus?

A

Globus major

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the function of the epididymus? 3

A
  1. Conveys sperm to SV (SV are reservoirs for seminal fluid)
  2. Stores small quantities of sperm
  3. Maturation of sperm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is an appendix epididymis? What is it typically seen with?

A
  1. Remnant of mesonephric (wolffian) duct
  2. Typically seen with hydrocele
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What does the spermatic cord connect?

A

Testes to pelvis/abdomen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What does the spermatic cord do?

A

Suspends testes in scrotum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Where does the spermatic cord travel through?

A

The inguinal canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What does the spermatic cord contain? 5

A
  1. Vas deferens
  2. Arteries
  3. Pampiniform plexus
  4. Lymphatic
  5. Nerves

Ln pav

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the arterial supply for the scrotum? 3

A
  1. Testicular arteries
  2. Deferential arteries
  3. Cremasteric arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Where does the testicular arteries originate and what doe they supply? 2

A
  1. Aorta, anterior origin
  2. Supply the testicles
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Where is the origin of the deferential arteries? What do they supply?

A
  1. Inferior vesical artery
  2. Supply epididymus and vas deferens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Where is the origin of the cremasteric arteries? And what do they supply?

A
  1. Inferior epigastric artery
  2. Supply peri testicular tissue
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Where does venous drainage happens in the scrotum? Where does each side drain into?

A
  1. Via pampiniform plexus
  2. Empties into testicular veins
  3. Right drains into the IVC
  4. Left drains into the LRV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Will we use doppler for scrotal ultrasound?

A

Yes,
1. Testicular artery- low resistance
2. Cremasteric and deferential - high resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the patient prep for a scrotal ultrasound?

A
  1. Patient in supine position
  2. Scrotum supported with towels
  3. Penis covered with towel
  4. Comfortable room temp, warm gel
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

When palpable masses what must we do? 3

A
  1. Request the patient localize the palpable mass
  2. Once localized, request permission to touch the patient and palpate the mass (individual site policies may require a chaperone)
  3. If consent given, palpate the region of interest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the traducer we will use for scrotal ultrasound?

A

12MHz transducer or higher

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How do we document the scrotum? What do we assess? 4

A

Two planes and assess
1. Epididymis
2. Blood flow in testicles
3. Scrotal wall thickness
4. Transverse of both testes together

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What do we look for during a sagittal scrotal ultrasound?

A
  1. Lateral, mid, medial
  2. Epi head/ superior testicle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What do we look for during a transverse image of a scrotum?

A
  1. Superior
  2. Mid
  3. Inferior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Why would we look for scrotum on ultrasound? 8

A
  1. Palpable masses
  2. Pain
  3. Enlarged scrotum
  4. Cystic vs solid
  5. Torsion
  6. Undescended testes
  7. Trauma
  8. Post orchiectomy

Pet put pc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the normal sonographic appearance of testes? 2 (echo textures)

A
  1. Homogenous
  2. Medium levels of echoes (similar to the thyroid)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the sonographic appearance of the mediastinum for each plane? (sag + trans)

A
  1. Sagittal: hyperechoic line from superior to inferior
  2. Transverse: Hyperechoic region medially (3 RT/ 9LT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the sonographic appearance of the rete testis? Are they easy to identify

A
  1. Decreased echogenicity at mediastinum or tiny cystic areas
  2. Difficult to identify normally
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the sonographic appearance of the epididymis? 2

A
  1. Isoechoic or slightly hyperechoic to the testicle
  2. Slightly coarser
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

For scrotal pathology how close to ______% sensitivity in detecting intrascrotal masses

A

100%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

For Scrotal pathology, extratesticular masses are what?

A

Benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

For intratesticualr masses scrotal pathology is what?

A

Malignant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is cryptorchidism? Where is it common?

A
  1. Undescended testicle
  2. Higher incidence in premature infants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the most common Genital urinary abnormality in children?

A

Cryptorchidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Cryptorchidism is typically causes the testes to be what?

A

Unilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Majority or cryptorchidism is located where?

A

80% located in inguinal canal and palpable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is gubernaculum?

A

The structure that guides and anchors the testis during descent into the scrotal sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What three factors can interrupt the descent of testes?

A
  1. Deficiency of gonadotropin normal stimulation
  2. Adhesions or anatomical maldevelopment
  3. Idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are some complications of Undescended testes? 2

A
  1. Infertility
  2. 48x risk of testicular cancer
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the treatment of Undescended testes? 2 (adults and children)

A
  1. Orchiopexy (children)
  2. Orchiectomy (adults)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is does Undescended testes look like sonographically? 5

A
  1. Oval or elongated mass (most likely in the inguinal canal)
  2. Smaller, less echogenic than normal
  3. Homogenous
  4. Mediastinum difficulty to identify
  5. Large lymph node&raquo_space;> Mistaken for testicle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are some testicular congenital anomalies? 3

A
  1. Polyorchidism
  2. Anorchia
  3. Testicular ectopia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is polyorchidism?

A

Testicular duplication

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is anorchia? Where is it more common?

A

Absence, more common on left

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is testicular ectopia?

A

Testicular tissue located anywhere along path of descent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is it hydrocele? Where do we usually see it?

A
  1. Collection of fluid between the tunica vaginalis layers (>2mm)
  2. Anterolateral scrotum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Is hydrocele congenital or acquired?

A

Both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What is the most common cause of painless scrotal swelling?

A

Hydrocele

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is a congenital scrotal pathology? When does it normally resolve itself? 2

A
  1. Patent processes vaginalis
  2. Usually resolves by 18 months
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is an acquired scrotal pathology? 3

A
  1. Idiopathic (most common)
  2. Infection, infarction, neoplasm
  3. Trauma (25%)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Large hydrocele rarely associated with what?

A

Neoplasms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Small hydrocele are seen in ______ of patients with what?

A
  1. 60%
  2. Testicular tumours
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What kindof pathology is a hydrocele?

A

Benign Pathology

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is a hematocele? What does it look like? 4

A
  1. Blood in the scrotal sac
  2. Thick scortal wall
  3. Anechoic > variable
  4. Septations, debris
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What is a pyocele?

A

Pus in the scrotal sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What does pyocele look like sonographically? 4

A
  1. Echogenic
  2. Septations/ loculation
  3. Thick scrotal wall
  4. Focal mural calcifications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What is a varicocele?

A

Dilated veins in the pampiniform plexus (>2mm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

How does varicoceles happen? Typically on which side?

A
  1. Obstructed venous return
  2. Typically occur on the left side
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What is the primary cause of varicocele? Who is affected? Can we correct it?? Why does it happen?

A
  1. Idiopathic
  2. 15-25 years of age
  3. Correctable infertility
  4. Incompetent valves in spermatic vein
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What are some secondary causes of varicocele? What should we look for? What is it called sometimes?

A
  1. Pressure on spermatic veins
  2. Look for mass
  3. “Nutcracker” syndrome
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What should doing the valsalva do to a varicocele when the patient standing? 2

A
  1. Should increase the size of the veins
  2. Primary will return to normal in supine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Does the patient position change the appearance of secondary varicoceles?

A

Does not!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

How do we demonstrate change in varicocele?

A

Valsalva

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What does the varicocele look like sonographically? 3

A
  1. Multiple anechoic structures >2mm
  2. At superior pole/ epididymis head
  3. Color flow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What are hernias? What might they contain 2

A
  1. Inguinal hernias that descend into the scrotum, usually containing omentum or bowel
  2. May contain mesentery, fat or bowel
91
Q

What is hernias associated with?

A

Heavy lifting

92
Q

What is trauma to the scrotum?

A

Direct or straddle injury to the scrotum

93
Q

What are effects of traumas to scrotums? 3

A
  1. Hematoma
  2. Hematocele
  3. Ruptured testicles
94
Q

Is a ruptured testicles a surgical emergency?

A

Yes

95
Q

What is the most common cause of a ruptured testicles?

A

Blunt trauma most common

96
Q

What is torn normally in a ruptured testicle?

A

Tunica albuginea

97
Q

For ruptured testes ____% of testicles are salvaged with surgery within ___ hours of surgery. Otherwise what will happen?

A
  1. 90%
  2. 72 hours
  3. Loss of function/ atrophy will occur
98
Q

What is the area that is blacked out?

A

Median raphe

99
Q

What is this an image of?

A

The bare area of the testicle

100
Q

What is this an image of?

A

Accessory Testicle

101
Q

What is this an image of?

A

Accessory Epididymis

102
Q

What is this an image of?

A

The testicle in Transverse

103
Q

What is this an image of?

A

Scrotum in Sagittal

104
Q

Label the image?

A

E: Epididymis
T: Testicle

105
Q

Label the image?

A

T: Testicle
E: Epididymis

106
Q

Label the images?

A

Undescended testes in
Left: 3 year old
Right: Adult

107
Q

What does the H mean?

A

Hydrocele

108
Q

What does the H mean?

A

Hydrocele

109
Q

What does the images demonstrate?

A

Hematocele

110
Q

What does this image demonstrate?

A

Pyocele

111
Q

What does these images demonstrate?

A

Varicocele

112
Q

What do these images represent?

A

Hernias

113
Q

What does these images represent?

A

Hernias

114
Q

What do these images demonstrate?

A

Acute Torsion

115
Q

What does these images demonstrate?

A

Chronic torsion

116
Q

What does these images demonstrate?

A

Epididymitis

117
Q

What does this image demonstrate?

A

Epididymitis

118
Q

What does these Images demonstrate? What do we note? 4

A

Trauma done to the testicles. Notice the:
1. Focal area of altered echogenicity
2. Irregular contour
3. Hematocele
4. Assess flow

119
Q

What is torsion? What are some effects of torsion?

A
  1. Spermatic cord twists
  2. Blood supply cut off to testicle
120
Q

Which population is usually afflicted with torsion?

A

Males <25 Years old

121
Q

If torsion happens what needs to be done?

A

Surgery within 6 hours

122
Q

If surgery is done within 6 hours in a torsion situation, how much is salvageable?

A

80-100%

123
Q

What happens to a testicle in torsion after 12 hours?

A

Complete infarction

124
Q

What are stages of torsion?

A
  1. Acute
  2. Subacute
  3. Chronic
125
Q

When does acute torsion happen?

A

within 24 hours

126
Q

When does subacute torsion occur?

A

1 to 10 days

127
Q

When does chronic torsion happen?

A

after 10 days

128
Q

What are two types of torsion?

A
  1. Intravaginal
  2. Extravaginal
129
Q

When is intravaginal torsion common?

A

During puberty

130
Q

What is intravaginal torsion?

A
  1. Anomalous suspension of testicle by long stalk of spermatic cord
  2. Testis rotates freely within the tunica vaginalis
131
Q

What increases the incidence of intravaginal torsion?

A

Orchiopexy

132
Q

What is intravaginal torsion also referred to?

A

Bell clapper deformity

133
Q

Label the images

A

A: Intravaginal torsion
B: Extravaginal torsion

134
Q

Which population is usually afflicted with extravaginal torsion?

A

Newborns

135
Q

What is extravaginal torsion?

A
  1. Poor/ absent attachment of testis to scrotal wall
  2. Both tunica vaginalis and spermatic cord under torsion as a unit
136
Q

What are some things we see during acute torsion? 5

A
  1. Enlarged testicle/ epididymis
  2. Testicle more hypoechoic
  3. Scrotal skin thickening
  4. Reactive hydrocele
  5. Absent arterial flow

Stear

137
Q

What does these images demonstrate?

A

Acute Torsion

138
Q

What is usually seen for the sub acute phase of torsion? 3

A
  1. Testicle enlarged
  2. Epididymis
  3. Heterogenous
139
Q

What does these images represent?

A

Sub acute phase

140
Q

What is seen during the chronic stage of torsion? 3

A
  1. Atrophied testicle
  2. Heterogeneous
  3. Epididymis remains enlarged
141
Q

What does these images demonstrate?

A

Chronic stage torsion

142
Q

What are some signs and symptoms of torsion? 3

A
  1. Sudden onset extreme pain
  2. N and V
  3. Symptoms may mimic epididymitis but diminish after 1 to 2 days
143
Q

Where does infection typically originate for the scrotal region? 3

A
  1. Bladder
  2. Urethra
  3. Prostate
144
Q

What is the most common cause of acute scrotal pain?

A

Epididymitis

145
Q

Epididymitis is what?

A

An infection/ inflammation of the epididymis

146
Q

What can epididymitis cause?

A

Infertility

147
Q

What are some symptoms of epididymitis? 4

A
  1. Fever
  2. Pain
  3. Dysuria
  4. Discharge
148
Q

What are some signs of epididymitis? 7

A
  1. Enlarged epididymis
  2. Hypoechoic/ heterogenous epididymis
  3. Scrotal thickening
  4. Possible reactive hydrocele
  5. Increased blood flow
  6. Possible abscess
  7. IF CHRONIC: Possible calcification

his pep

149
Q

What does this image demonstrate?

A

epididymitis

150
Q

What is Orchitis?

A

Inflammation of the testis

151
Q

How common is orchitis? And who is the common population?

A
  1. Very common secondary to epididymitis
  2. Most common cause in men <35: chlamydia
152
Q

What are three types of orchitis?

A
  1. Focal
  2. Diffuse
  3. Chronic
153
Q

What is focal orchitis? 2

A
  1. Hypo, mass like
  2. Hyper vascular
154
Q

What does diffuse orchitis look like?

A

Overall decrease in echogenicity and enlargement of the testis

155
Q

What does chronic orchitis look like?

A
  1. Hypoechoic, heterogenous
  2. Reactive hydrocele
156
Q

What is this an image of?

A

Focal Orchitis
It is hypervascular

157
Q

What is a abscess?

A
  1. Complication of epididymo-Orchitis
  2. Pyocele or fistula to skin
158
Q

The abscess can rupture through what?

A

The tunica vaginalis

159
Q

What are scrotal pearls? What is their etiology? Is it mobile?

A
  1. Calcifcations on tunica or within scrotal sac
  2. Unknown etiology
  3. Mobile
160
Q

What is a spermatocele? 2

A
  1. Retention cyst
  2. Dilated epididymal tubules filled with nonviable sperm
161
Q

Are spermatoceles painful?

A

No

162
Q

How many spermatoceles can one have?

A

Single/ multiple

163
Q

Who is usually affected by spermatoceles?

A

Middle aged men

164
Q

What anatomical area is usually affected by spermatocele?

A

Epididymal head

165
Q

Is spermatoceles palpable?

A

Yes

166
Q

How does one develop Spermatoceles?

A

Epididymitis or trauma

167
Q

What does these images demonstrate?

A

Spermatoceles. Note the:
1. Well defined
2. Anechoic
3. Enhancement
4. Simple, loculated, +/- Echogenic debris
5. 0.2- 9cm

168
Q

What are true cysts? Where are they found? 3

A
  1. Asymptomatic
  2. Serous fluid
  3. Epididymis, tunica albuginea, testicle
169
Q

What does these images represent?

A

True cysts

170
Q

What kindof tumor is Non-germ cell (gonodal stromal)? How much of testicular tumors does it represent?

A
  1. Majority Benign
  2. represents <5% of testicular tumors
171
Q

Who is usually afflicted with Non- Germ Cell (Gonodal stromal)?

A

20-50 years of age

172
Q

What are two types of non-germ cell (Gonodal stromal)?

A
  1. Leydig cell
  2. Sertoli cell
173
Q

What may leydig cell cause?

A

Gynecomastia

174
Q

What might sertoli cells cause?

A

Possible gynecomastia and feminization

175
Q

What does this image demonstrate? Why?

A

Non- germ cell Gonodal stromal

176
Q

What is a adenomatoid tumor? Where is it seen? 5

A
  1. Benign
  2. Slow growing
  3. Asymptomatic
  4. Small
  5. typically seen in the epididymis

bass

177
Q

What is the most common extravesicular tumor?

A

Adenomatoid tumor

178
Q

What are these images of? why?

A

Adenomatoid tumors. note the

  1. Well defined
  2. Variable echogenicity
  3. Solid masses
  4. Unilateral
  5. Typically left side

us wet

179
Q

What is microlithiasis?

A

Calcifications within seminiferous tubules

180
Q

What are the benign and malignant ranges for microlithiasis?

A
  1. Benign = <5
  2. Malignancy= >5
181
Q

What are some malignant pathologies? 8

A
  1. Painless scrotal enlargement, hardness of testicles
  2. Unilateral, hypoechoic
  3. 15-34 years of age
  4. originate from germ cells
  5. Divides into seminomas and non seminomatous tumors
  6. Increased vascularity
  7. Normal scrotal wall and epididymis
  8. 10% have reactive hydrocele

duo pin

182
Q

What is the most common germ cell tumor?

A

Seminoma

183
Q

Who is usually affected by seminoma?

A

30-40 years of age

184
Q

What is seminoma usually correlated with? 3

A
  1. Undescended testes
  2. Normal AFP
  3. Beta HCG may be elevated
185
Q

Which germ cell tumor is the least aggressive and has the best prognosis?

A

Seminoma

186
Q

What kind of tumors are Non-seminomatous germ cell tumors? Who do they affect?

A
  1. More aggressive > visceral metastases
  2. Younger patients
187
Q

What does NSGCT stand for?

A

Non- seminomatous germ cell tumor

188
Q

What is the 2nd most common germ cell tumor?

A

Embryonal cell tumor

189
Q

Who is most affected by Embryonal cell tumors?

A

Men aged 25-35 years

190
Q

What is the most aggressive type of germ cell tumor?

A

Embryonal cell tumor

191
Q

What is correlated with Embryonal cell tumors?

A

AFP may or may not be elevated

192
Q

What is a yolk sac tumor? Where is it most common

A
  1. Infantile form of embryonal cell tumors
  2. Most common GST in infants <2years
193
Q

What is a difference between embryonal cell and yolk sac tumor?

A

AFP is always elevated for yolk sac, Embryonal cells may or may not be elevated

194
Q

What does this image represent?

A

Embryonal cell tumors. Note the

  1. Hypoechoic
  2. Mixed echogenicity
  3. Poorly defined capsule
195
Q

What is a choriocarcinoma? What is the incidence rate for pulmonary involvement? Who is affected? Is it common?

A
  1. Highly malignant and aggressive tumor
  2. High incidence of pulmonary involvement
  3. Men aged 20-30 years are affected
  4. Uncommon
196
Q

What are some symptoms of choriocarcinoma?

A

Gynecomastia/ scrotal pain

197
Q

What is HCG look like for choriocarcinoma?

A

Serum Beta HCG is always elevated

198
Q

What does this image demonstrate?

A

Choriocarcinoma

199
Q

How frequent is teratoma? How does it affect children and adults?

A
  1. Lowly frequent
  2. In children typically benign
  3. In adults typically malignant
200
Q

What do we see for teratoma in terms of hormones? what does it suggest?

A
  1. AFP and BHCG may be elevated
  2. Suggestive of malignancy
201
Q

What does this image demonstrate? Why?

A

Teratoma note the
1. Cystic/ Solid components
2. Posterior shadowing or enhancement
3. Well defined boarders

202
Q

What is the most common mixed germ cell tumor?

A

Teratocarcinoma

203
Q

What is the most aggressive, largest heterogenous tumor?

A

Teratocarcinoma

204
Q

What is the echogenicity of a mixed germ cell tumor? 2

A
  1. Cystic areas
  2. Echogenic foci
205
Q

What does this image demonstrate?

A

Mix cell tumor

206
Q

What is a burned-out tumor?

A

Echogenic or calcified scar in the testicle that represents regression of a primary testicular tumor (The primary tumor outgrows its blood supply and regresses)

207
Q

What does patients with burned out tumors present with? 3

A
  1. Mets
  2. Unknown primary
  3. Testicles that are normal on physical exam
208
Q

What is the most common metastatic tumor of the testes?

A

Lymphoma

209
Q

When is metastatic tumors more prevalent in men?

A

> 50 years

210
Q

What is the most common type of lymphoma?

A

Non-hodgkin’s

211
Q

What is the most common presentation of Lymphoma?

A
  1. Painless testicular mass
  2. Diffuse enlargement
212
Q

What does this image demonstrate?

A

Lymphoma. Note the
1. Hypoechoic, homogenous
2. Diffuse or focal mass
3. Hyper vascular

213
Q

What is the second most common secondary testicular neoplasm?

A

Leukemia

214
Q

What is the most common non-lymphomatous metastatic tumor?

A

Prostate and lung

215
Q

What are some possible routes of metastatic spread?

A
  1. Retrograde venous
  2. Hematogenous
  3. Retrograde lymphatic
  4. Direct tumor invasion

hi lv

216
Q

What kind of changes occur in post vasectomy patients? How many are affected?

A

45% of patients experience epididymal changes

217
Q

Besides epididymal changes what else presents in post vasectomy patients? 5

A
  1. Epididymal enlargement
  2. Heterogenous appearance
  3. Cyst/ spermatoceles
  4. Sperm granuloma
  5. Tubular ectasia

chest

218
Q

What is tubular ectasia?

A

Various sized cystic lesions that affect the epididymis and rete testis

219
Q

Should there be colour flow in tubular ectasia?

A

No

220
Q

What should tubular ectasia look like? What is it associated with?

A
  1. Bilateral/ asymmetrical
  2. Spermatocele
221
Q

Is there colour flow with tubular ectasia?

A

No

222
Q

What is tubular ectasia usually mistaken for?

A

Neoplasm

223
Q

What does this image demonstrate?

A

Tubular ectasia

224
Q

For a post orchiectomy patient what should we assess for? 4

A
  1. Hematomas
  2. Abscesses
  3. Recurrent neoplasms
  4. Prosthesis

harp