Testicular Tumors

How does a seminoma look?

appears yellow-white with rare focal areas of hemorrhage and necrosis

What is the jutting of the tumor after you cut the prostate?

bosselation

What is a totipotential germ cell tumor?

embryonal carcinoma

What disease accounts for: -half of all germ cell tumors -not found before puberty and most patients are between the ages of 25 and 55 -90% are classic type

seminoma

What is an undifferentiated germ cell tumor?

seminoma

What is the #1 testicular cancer?

seminoma

What tumor is poorly defined, lobulated masses that are yellow-gray on cut section, with focal areas of hemorrhage and necrosis?

yolk sac tumor

What two results come from an extraembryonic differentiation of an embryonal tumor?

yolk sac tumor (from the yolk sac) and a choriocarcinoma (from the placenta)

What are the 3 classification of testicular teratomas?

1) mature teratoma 2) immature teratoma 3) malignant teratoma

What are the 3 circumstances that have been demonstrated to be associated with an increased risk of germ cell tumors?

1) prior diagnosis of a germ cell tumor in contralateral testis 2) prior diagnosis of a testicular germ cell tumor in a first degree family member 3) abnormal germ cells in gonadal dysgenesis (klinefelter and crytporchidism)

What are the 3 most frequent patterns of mixed germ cell tumors?

1) teratoma with embryonal (teratocarcinoma) 2) teratoma, embryonal, and seminomas 3) embryonal and seminomas

In what percent of cases are the tunica albuginea and epididymis invaded?

20%

What percentage of patients are initially presented with metastasis, usually embryonal?

20%

Occasionally, embryonal carcinomas may stain for what tumor markers?

Beta-HCG and AFP

Which tumor usually develops within the first four decades of life? -well circumscribed -yellow-gray solid tumors -80% are benign -have a tubular arrangement with solid cords of cells with a fibrous trabecular network -most come to medical attention because of a mass in the scrotum or endocrine effects (gynecomastia) -orchioectomy is curative

Sertoli Cell Tumor

What defect is found on 90% of testicular germ cell tumors?

a defect on the short arm of chromosome 12

What is a Schiller-Duval Body?

a microcyst containing a glomerulus-like structure with a central fibrovascular core

What tumor disseminates to the lung by hematogenous routes?

choriocarcinoma

What tumor is a highly malignant testicular tumor, which represents germ cell extraembryonic differentiation to the components of the placenta, namely, cyto and syncytiotrohpoblast? -the cut surface contains marked hemorrhage and necrosis

choriocarcinoma

What results from germ cell tumors? -after 5-20 years?

cytological atypia of germ cells within seminiferous tubules -after 5-20 years, the cancer can cross the basement membrane and an invasive malignant disease develops

What is the most common ovarian tumor in women of reproductive years?

dermoid cyst

When teratomas arise from the ovary, what are they called?

dermoid cyst

What is the second most common germ cell tumor? -do not occur before puberty, and most are found between the ages of 20 and 35 -more aggressive and lethal than seminomas -tumor is small and does not replace the whole testis -on sectioning, it is gray-white, poorly demarcated, and bulging, with hemorrhage and necrosis

embryonal carcinoma

What presents as testicular swelling or pain? -spread by first invading the epididymis and by metastasizing to regional lymph nodes and to the lungs -5 yr survival rate is >80%

germ cell tumor

Which tumor are rare neoplasms that are functionally active, secreting androgens, estrogens, or both? -well-circumscribed and appears encapsulated -cut surface is yellow brown and lobulated -tumor reveals sheets of polygonal cells with abundant eoisinophilic cytoplasm -90% are benign -all are cure by orchioectomy

leydig cell tumors

Embryonal carcinomas usually metastasize to which places?

lymph nodes and distant organs such as the lungs and liver

What is a solid and multicystic lesion that enlarges the testis? -the cut surface exhibits mucinous cysts, with solid cartilaginous and osseous foci

mature teratoma

Pure tumors are rare and mostly observed as a component of what?

mixed germ cell tumor

What are the characteristics of germ cell tumors in terms of race, and the amount this has increased in the last 40 years?

more common in whites, and has doubled in last 40 years

Stromal invasion gives rise to what two tumors?

seminoma and embryonal carcinoma

Which disease has a great prognosis because they are extremely sensitive to radiation therapy and chemotherapy for advanced cases? -tumor replaces the whole testis

seminomas

What are large multinucleated giant cells with abundant vacuolated cytoplasm, which contains HCG?

syncytiotrophoblast

If a embryonal carcinoma undergoes somatic differentiation, what does it become?

teratoma

What germ cell tumors are characterized by tissue form all three germ layers? -comprise almost half of the germ cell tumors in infants and children but less than 5% of tumors in adults

testicular teratomas

What is the most important predictor of the biological behavior of a testicular teratoma?

the age of the patient

What is the most common germ cell tumor in children?

yolk sac tumor

What cancer marker is used for yolk sac tumor?

AFP

In a yolk sac tumor, tumor cells surround a characteristic structure called a ?

Schiller-Duval Body