Germ Cell Tumors of the Testis Overview

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Questions and Answers

What is the most common malignancy of the testicles?

Seminoma

Which age group is most commonly affected by seminomas?

  • 50-60
  • 20-30
  • 10-20
  • 30-50 (correct)

What are the clinical signs and symptoms of a seminoma?

  • Painful scrotal mass
  • Hardening of the testicle (correct)
  • Elevated hCG (correct)
  • All of the above

What kind of sonographic appearance does a seminoma typically exhibit?

<p>Solid hypoechoic intratesticular mass</p> Signup and view all the answers

Embryonal cell carcinomas are less aggressive than seminomas.

<p>False (B)</p> Signup and view all the answers

Which of these are clinical signs and symptoms of an embryonal cell carcinoma?

<p>Palpable mass (A), Elevated AFP (B), Elevated hCG (C)</p> Signup and view all the answers

What sonographic characteristics are typical of an embryonal cell carcinoma?

<p>Heterogenous mass with cystic components (A), Areas of increased echogenicity (B), Calcification (C)</p> Signup and view all the answers

Teratomas are always malignant.

<p>False (B)</p> Signup and view all the answers

Which of these is a clinical sign and symptom of a teratoma?

<p>Palpable mass (A)</p> Signup and view all the answers

What sonographic characteristics are present in a teratoma?

<p>Heterogenous mass with calcifications (A), Presence of bone, teeth, cartilage, hair (B), Hyperechoic microcalcifications (C)</p> Signup and view all the answers

Yolk sac tumors are a rare type of testicular cancer with unfavorable prognosis.

<p>False (B)</p> Signup and view all the answers

Which of these is a clinical sign and symptom of a yolk sac tumor?

<p>Palpable mass (A), Elevated AFP (B)</p> Signup and view all the answers

What sonographic characteristics are typically seen in a yolk sac tumor?

<p>Heterogenous mass (A), Areas of hemorrhage (B), Calcifications (C)</p> Signup and view all the answers

Choriocarcinomas are common and benign tumors.

<p>False (B)</p> Signup and view all the answers

Which of these is a clinical sign and symptom of a choriocarcinoma?

<p>Palpable mass (A), Elevated hCG (B)</p> Signup and view all the answers

What sonographic characteristics are typical of a choriocarcinoma?

<p>Varied appearance (A), Heterogenous mass (B), Areas of hemorrhage, necrosis, and calcifications (C), Irregular borders (D)</p> Signup and view all the answers

Germ cell tumors are not associated with elevated levels of human chorionic gonadotropin and alpha-fetoprotein.

<p>False (B)</p> Signup and view all the answers

Approximately 95% of testicular tumors are germ cell type and highly malignant.

<p>True (A)</p> Signup and view all the answers

What are the main types of germ cell tumors (GCTs)?

<p>Seminoma (A), Teratoma (B), Embryonal cell carcinoma (C), Yolk sac tumor (D), Choriocarcinoma (E)</p> Signup and view all the answers

What are the two main categories of testicular tumors?

<p>Both A and B (B)</p> Signup and view all the answers

Testicular carcinoma is a common type of testicular tumor and occurs most often in older men.

<p>False (B)</p> Signup and view all the answers

Which of these are symptoms of testicular carcinoma?

<p>Painless palpable lump (A), Testicular enlargement (B), Vague discomfort in the scrotum (C)</p> Signup and view all the answers

Flashcards

SEMINOMA

Most common malignancy of testicles

SEMINOMA ages

Most common in ages 30-50

SEMINOMA Clinical S & S

Painless scrotal mass, hardening of testicle, elevated hCG

SEMINOMA Sonographic appearance

Solid hypoechoic intratesticular mass, heterogeneous if large

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EMBRYONAL CELL CARCINOMA

More aggressive than seminomas

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EMBRYONAL CELL CARCINOMA Clinical S & S

May be palpable, elevated AFP & hCG

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EMBRYONAL CELL CARCINOMA Sonographic appearance

Heterogenous mass with cystic components

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TERATOMA

Benign with malignant potential

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TERATOMA Clinical S & S

May be palpable, elevated AFP & hCG when malignant

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TERATOMA Sonographic appearance

Heterogenous mass with calcifications

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YOLK SAC TUMOR

Rare, favorable prognosis, not as aggressive

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YOLK SAC TUMOR Clinical S & S

May be palpable, elevated AFP only

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YOLK SAC TUMOR Sonographic appearance

Heterogenous mass with hemorrhage and calcifications

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CHORIOCARCINOMA

Rare; aggressive

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CHORIOCARCINOMA Clinical S & S

May be palpable, elevated hCG

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CHORIOCARCINOMA Sonographic appearance

Varied due to mixed cell types; heterogenous mass

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GERM CELL TUMORS

Associated with elevated levels of hCG and AFP

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Approximately 95 % of testicular tumors

Are germ cell type and highly malignant

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Types of GCT

Seminoma, Teratoma, Embryonal cell carcinoma, Yolk sac tumor, Choriocarcinoma

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Testicular Carcinoma

Uncommon germ cell and non-germ cell tumors

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Testicular Carcinoma Occurs

Frequently between ages of 20 and 34

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Symptoms of Testicular Carcinoma

Painless palpable lump, testicular enlargement, vague discomfort in scrotum

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Study Notes

Germ Cell Tumors of the Testis

  • Seminoma:

    • Most common testicular malignancy.
    • Typically occurs in men aged 30-50.
    • Presents as a painless, hard scrotal mass.
    • Elevated levels of human chorionic gonadotropin (hCG) may be present.
    • Sonographic appearance: Solid, hypoechoic intratesticular mass; heterogeneous if large.

  • Embryonal Cell Carcinoma:

    • More aggressive than seminomas.
    • May present with a palpable mass and elevated levels of alpha-fetoprotein (AFP) and hCG.
    • Sonographic appearance: Heterogeneous mass with cystic components, possibly areas of increased echogenicity (calcification, hemorrhage, or fibrosis).

  • Teratoma:

    • Can be benign but has malignant potential.
    • May be palpable.
    • Elevated AFP and hCG levels may suggest malignancy.
    • Sonographic appearance: Heterogeneous mass with calcifications; may contain bone, teeth, cartilage, hair (hyperechoic microcalcifications, shadowing).

  • Yolk Sac Tumor:

    • Rare; favorable prognosis compared to other germ cell tumors.
    • Not as aggressive as other types.
    • Typically presents with a palpable mass and elevated AFP only.
    • Sonographic appearance: Heterogeneous mass with areas of hemorrhage and calcifications.

  • Choriocarcinoma:

    • Rare; highly aggressive.
    • May present with a palpable mass and elevated hCG.
    • Sonographic appearance: Varies due to diverse cell types; heterogeneous mass with areas of hemorrhage, necrosis, and calcifications; and irregular borders.

General Testicular Cancer Information

  • Germ Cell Tumors (GCTs):

    • Account for approximately 95% of testicular cancers, often highly malignant.
    • Associated with elevated levels of hCG and AFP.
    • Include: Seminoma, Teratoma, Embryonal cell carcinoma, Yolk sac tumor, Choriocarcinoma.

  • Testicular Carcinoma:

    • Includes both germ cell and non-germ cell types.
    • More common between ages 20-34.
    • Symptoms: Painless palpable lump, testicular enlargement, or vague scrotal discomfort.

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