Flashcards in Testicular Tumors Deck (29)
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1
NAme the germ cell testicular tumors
-Seminoma
-Embryonal Carcinoma
-Yolk sac tumors
-Choriocarcinoma
-Teratoma
2
Risk factors for germ cell tumors
-Cryptochidism
-Prior TGCT
-Fam hx
-Infertility
3
Intratubular Germ Cell Neoplasia
-Adj to all germ cell tumors in adults, except spermatocytic seminoma
4
Seminoma
-Most common pure germ cell tumor composed of relatively uniform cells with abundant clear cytoplasm, well defined cell borders and nuclei with one or more prominent nucleoli
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What is seminoma analogous to in females?
Dysgerminoma
6
Seminoma: presentation
-Most common painless testicular mass
-Unilateral
-Bulky mass
-Homogeneous
-Gray white
-Lobulated
-Devoid of hemorrhage and necrosis
7
Seminoma: histology
-Sheets of uniform cells
-Divided into poorly demarcated lobules by delicate septa of fibrous tissue, septa are infiltrated by T cells
-Large and round cells
-Clear and watery cytoplasm
-Large, central nucleus
-Prominent nucleolus
-May contain granulomas*
-May have syncytiotrophoblasts so serum hCG may be elevated (less that choriocarcinoma though)
8
Seminoma: treatment
-Good prognosis
-Stage I: orchiectomy and radiation
-Stage II: radical orchiectomy plus inguinal and radiation or combo chemo
-Stage III: Radical inguinal orchiectomy and multidrug chemo
9
Embryonal Carcinoma
Germ cell tumor composed of cells with epithelial appearance and marked cytologic atypia
10
Embryonal Carcinoma: gross
-Poorly demarcated
-Foci of necrosis and hemorrhage
-Extra testicular involvement
11
Embryonal Carcinoma: prognosis
Poor
12
Yolk Sac Tumor
Germ cell tumor characterized by variety of growth patterns that recapitulate yolk sac, allantois, and extra embryonic mesenchyme
13
Yolk Sac Tumor: incidence
Common pediatric cancer, rare in adults
14
Yolk Sac Tumor: presentation
-non symptomatic rapid testicular enlargement
-non encapsulated
-hemorrhagic, yellow, white, myxoid gelatinous
15
Yolk Sac Tumor: histologic
-AFP pos tumor (alpha fetoprotein)
-Schiller duval body
-Intracellular eosinophilic globules
16
Yolk Sac Tumor: treatment
-Take it out
17
Choriocarcinoma
Germ cell tumor composed of mononucleated cytotrophoblast and multinucleated syncytiotrophoblast
18
Choriocarcinoma: epi
-Usually part of a mixed tumor
-Young adults 25-30=most common
19
Choriocarcinoma: presentation
-Aggressive, but small
-Hemorrhagic and necrotic
-Metastasis widespread
20
Choriocarcinoma: Lab tests
High hCG levels
21
Choriocarcinoma: prognosis
Bad, hCG levels correlate with prognosis
22
Choriocarcinoma: treatment
Take it out and chemo
23
Choriocarcinoma: histology
Syncytiotrophoblast make giant cells
24
Teratoma
Tumors with more than one somatic tissue of different germinal layers. Second most common childhood germ cell tumor. Children <4 and adults between 20 and 40 get them
25
Teratoma: gross
-Well circumscribed
-Hetergeneous
-Nodular and firm to cystic
-Cysts filled with clear white, flaky gelatinous or mucoid material
-Mature tissue often present
26
Teratoma: mature
Can differentiate, benign
27
Teratoma: immature
Undifferentiated/primitive, malignant
28
Teratoma: secondary malignant transformation
Can be sarcomatous or carcinomatous
29
