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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

5

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

Teratoma: treatment

-Take it out
-Adult teratomas are malignant