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urology final boss > testicular tumors/ Germ cell tumor of testis > Flashcards

testicular tumors/ Germ cell tumor of testis Flashcards

1
Q

Epidemiology of testicular tummors

A

95-97% of all TT are Germ cell tumors

10% of all malignancies in the UGS

3-6% of all malignancies in men

1-3% of cases are bilateral

presenting ages = 20-40 y/o men

usually presents on the Right side

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2
Q

what % of all TT are Germ cell tumors

A

95-97%

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3
Q

what percentage do TT make up of malignancies in the UGS

A

10%

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4
Q

what percentage do TT make up of all malignancies in men

A

3-6%

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5
Q

what percentage of cases of TT are bilateral

2 types of presenting bilateral tumors

A

1-3%

Synchronous = present at the same time

Metachronous = Present at different times usually right side first d/2 cryptochordism. usuallly met from the 10 tumor in other side

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6
Q

abnormal undescended PW

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7
Q

presenting ages of TT

A

20-40 y/o men

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8
Q

What are the 4 RF of TT

which is the MC

what other pathology is assoc with it

A
  1. Cryptochordmism
    • _​​_abdominal crypto= 1/20
    • inguinal cyrpto = 1/80
  2. Testicular dysgenesis i. e Klinefelters
  3. Inguinal herina usually assoc w/ crypto
  4. Testicular Trauma leading to Induration
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9
Q

Pathological Classification of TT according to WHO 2016

A
  1. Germ cell (mg)
    1. Seminomatous (ClASp)
      • Classical
      • Spermatocytic
      • Anaplastic
    2. Non-seminomatuos (Choreo-TIME)
      • Intracellular germ cell neoplasia
      • Embryonal
        • adult
        • infantile
      • Choriocarcinoma
      • Teratoma
      • Mixed
  2. Non Germ Cell (bg, rare, non clinical meaning)
    • Leydig
    • Sertoli
    • Gonadoblastoma
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10
Q

types of Seminomatous Germ cell tumors

SEMINOMATOUS ClAsp

A

Classical

Spermatocytic

Anaplastic

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11
Q

types of Non-seminomatuos Germ cell tumors

Choreo-TIME

which has hematogenous spread

types of embryonal

types of tumors in mixed what’s the prog

A
  • Intracellular germ cell neoplasia
  • Embryonal
    • adult
    • infantile e.g. Teiluris= quick death d/2 aggressive nature
  • Choriocarcinoma very small and aggressive. hematogenous spread
      • Teratoma
    • Mature
    • Immature w/ malig component e.g. Teratocarcinoma
  • Mixed 60% have more than 1 histological types w/ unfavourable prognosis
    • Seminoma combo w/ Embryonal
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12
Q

Non Germ Cell tumors (bg, rare, non clinical meaning)

SLG

A
  1. Leydig
  2. Sertoli
  3. Gonadoblastoma
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13
Q

what determines the clinical and pathological staging of TT

A
  1. TNM 2017
    2.
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14
Q

what is the

AJCC

UICC

where are they accepted

when are they accepted world wide

A

American Joint Commitee on Cancer = accepted in US

Union International Comitte on Cancer = accepted in EU

if both are present they are accepted internationaly

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15
Q

what is the TNM 2017 system

what does N stand for

A

TNM 2017

gathers information about the the extent of a tumour to define the TNM category before and after surgery

N = regional LN centre of the specific tumor

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16
Q

what is the N (Regional LN centre of TT)

A

Lumbar Retroperitoinaeal L.N’S

below the kidney at the site of testes Embryological origin

  1. PreCaval
  2. ParaCaval
  3. IntraAortoCaval
  4. ParaAortic
  5. PreAortic
17
Q

how do TT spread (met)

what’s the exception

A

Lymphogenous spread

except Choriocarcinoma (NSGCT) which has Hematogenous spread

18
Q

Clinical Presentation of TT

A
  • Painless testicular englarment
  • Induration( localised hardening of soft tissue)
  • Nodes in the testes
  • Scrotal Mass ( 2 types dx by U.S)
    • Intratesticular
    • Extratesticular
19
Q

3 phases of the evolution of TT

A
  1. Latent Phase
    • e.g. Intratubular GC neoplasia
    • found incidentally by self palpaption, US
  2. Clinically manifested Phase
  3. Advanced Phase
20
Q

dg of TT

A
21
Q

dx dg of TT

A

epididymitis & testicular torsion

22
Q

treatment of TT

how does histological report affect post op rx

specific rx for Choriocarcinoma

A

urology final boss (22 decks)

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