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L4 (T3): Pathology of the testis
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L4 (T3): Pathology of the testis

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Questions and Answers

Which age group most commonly experiences acute epididymo-orchitis?

  • Men aged 20 – 39 years (correct)
  • Men aged 40 – 59 years
  • Men aged 80 years and above
  • Men aged 60 – 79 years

    • What are the most common sexually transmitted diseases associated with acute epididymo-orchitis?

  • Syphilis and Trichomoniasis
  • Herpes simplex virus and Human papillomavirus
  • Hepatitis B virus and Human immunodeficiency virus
  • Chlamydia trachomatis and Neisseria gonorrhoea (correct)

    • What is the most common cause of acute epididymo-orchitis in older men over 40 years?

  • Streptococcus pneumoniae
  • Staphylococcus aureus
  • Haemophilus influenzae
  • E. coli (correct)

    • What is the classification of testicular cancer into?

    <p>Seminomatous and non-seminomatous germ cell tumours</p> Signup and view all the answers

    What age group commonly experiences most cases of acute epididymo-orchitis?

    <p>20 – 39 years</p> Signup and view all the answers

    What are the predisposing factors of testicular cancer?

    <p>Undescended testis and family history of testicular cancer</p> Signup and view all the answers

    What are the biochemical and radiological investigations for testicular cancer?

    <p>Tumor markers and ultrasound</p> Signup and view all the answers

    What are the radiological, gross and histological features of testicular seminoma, teratoma and other germ cell tumors?

    <p>Seminoma: Homogeneous mass; Teratoma: Solid and cystic components; Other germ cell tumors: Variable appearance</p> Signup and view all the answers

    What is the basic understanding of staging and prognosis of testicular cancer?

    <p>Staging is based on TNM system; Prognosis is generally good, especially for early stages</p> Signup and view all the answers

    What is the basic understanding of treatment of testicular cancer?

    <p>Surgery, chemotherapy, and radiation therapy</p> Signup and view all the answers

    Which type of testicular cancer is the most common in men aged 30-34?

    <p>Seminomatous germ cell tumors</p> Signup and view all the answers

    What is the characteristic feature of seminomas?

    <p>Slow growth</p> Signup and view all the answers

    What is the most common cause of acute epididymo-orchitis?

    <p>Inflammation and neutrophil predominance</p> Signup and view all the answers

    What is the recommended timeframe for 'untwisting' the spermatic cord in cases of torsion?

    <p>Within 6 hours</p> Signup and view all the answers

    What is the most common type of non-seminomatous germ cell tumor?

    <p>Embryonal carcinoma</p> Signup and view all the answers

    What is the primary management approach for acute epididymo-orchitis?

    <p>Culture and sensitivity testing, antibiotics, pain relief, and scrotal elevation</p> Signup and view all the answers

    What is the potential consequence of chronic epididymo-orchitis?

    <p>Scarring and sterility</p> Signup and view all the answers

    Which factor is NOT associated with an increased risk of testicular cancer?

    <p>Exposure to estrogen</p> Signup and view all the answers

    What is the most common presentation of torsion?

    <p>Sudden testicular pain</p> Signup and view all the answers

    Which type of testicular cancer occurs in men in their late teens and early 30s?

    <p>Non-seminomatous germ cell tumors</p> Signup and view all the answers

    Which tumor marker is associated with choriocarcinoma and embryonal carcinoma?

    <p>Human chorionic gonadotropin (HCG)</p> Signup and view all the answers

    What is the characteristic macroscopic appearance of seminoma?

    <p>Potato-like appearance with no haemorrhage or necrosis</p> Signup and view all the answers

    What is the most likely diagnosis for a 22-year-old with a testicular mass showing partly cystic and partly solid appearances on ultrasound, and normal tumor markers?

    <p>Teratoma</p> Signup and view all the answers

    What is the common presentation of advanced testicular cancer with metastases to the lungs?

    <p>Cough, chest pain, haemoptysis and shortness of breath</p> Signup and view all the answers

    What is the primary purpose of a PET scan in testicular cancer management?

    <p>To detect recurrent disease after treatment</p> Signup and view all the answers

    What is the microscopic feature of seminoma cells?

    <p>Large with prominent lymphocytic infiltrate</p> Signup and view all the answers

    What is the most likely diagnosis for a 32-year-old man with heterogeneous bilateral testicular tumors and mixed cystic and solid components on CT scan?

    <p>Mixed germ cell tumor</p> Signup and view all the answers

    What is the primary role of tumor markers in testicular cancer?

    <p>To aid in making a diagnosis of cancer in the presence of a testicular mass</p> Signup and view all the answers

    What is the characteristic macroscopic appearance of early teratoma?

    <p>Irregular tumour with cystic cut surface and mucin secretion</p> Signup and view all the answers

    What is the imaging modality of choice to distinguish between a complex cyst (most likely malignant) and a simple cyst (most likely benign) in testicular cancer?

    <p>Ultrasound scan (USS)</p> Signup and view all the answers

    Which type of testicular cancer is commonly associated with increased levels of alpha-fetoprotein and human chorionic gonadotropin?

    <p>Yolk sac tumor</p> Signup and view all the answers

    What is the most common cause of acute epididymo-orchitis in older men over 40 years?

    <p>Escherichia coli</p> Signup and view all the answers

    What is the primary imaging modality of choice to distinguish between a complex cyst (most likely malignant) and a simple cyst (most likely benign) in testicular cancer?

    <p>Ultrasound</p> Signup and view all the answers

    What is the characteristic microscopic feature of seminoma cells?

    <p>Schiller-Duval bodies</p> Signup and view all the answers

    What is the primary management approach for acute epididymo-orchitis?

    <p>Antibiotic therapy</p> Signup and view all the answers

    Which factor is NOT associated with an increased risk of testicular cancer?

    <p>History of vasectomy</p> Signup and view all the answers

    Which type of testicular cancer tends to grow and spread more slowly than non-seminomatous tumors?

    <p>Seminomatous tumors</p> Signup and view all the answers

    Which exposure is associated with a higher risk of testicular cancer in males?

    <p>Exposure to estrogen in utero</p> Signup and view all the answers

    What is the most common type of testicular cancer, with over 90% of testicular cancers arising from it?

    <p>Germ cell tumors</p> Signup and view all the answers

    What is the primary risk factor for developing testicular cancer?

    <p>Family history of cancer</p> Signup and view all the answers

    Which type of testicular tumors are classified into germ cell tumors and sex cord-stromal tumors?

    <p>Testicular lymphoma</p> Signup and view all the answers

    What is the most common subtype of testicular cancer affecting men between 25 and 45 years of age?

    <p>Classical seminoma</p> Signup and view all the answers

    What is the recommended management for acute epididymo-orchitis?

    <p>Antibiotics, pain relief, and supportive care</p> Signup and view all the answers

    What is the macroscopic appearance of normal testes?

    <p>Yellow-brown appearance and soft seminal tubules</p> Signup and view all the answers

    What is the age group most commonly affected by acute epididymo-orchitis?

    <p>22-39 years</p> Signup and view all the answers

    What is the characteristic feature of seminomas?

    <p>Sheets of uniform cells with clear cytoplasm and central nuclei</p> Signup and view all the answers

    What is the common presentation of advanced testicular cancer with lung metastases?

    <p>Dyspnea and non-productive cough</p> Signup and view all the answers

    What is the primary focus of the lecture regarding testicular cancer classification?

    <p>Clinical, biological, and radiological investigations</p> Signup and view all the answers

    Which type of testicular tumor is common in men in their teens or early thirties?

    <p>Embryonal carcinoma</p> Signup and view all the answers

    Which type of testicular tumor is rare in adults and has a good prognosis in children?

    <p>Yolk sac tumor</p> Signup and view all the answers

    Which type of testicular tumor is rare, fast-growing, and tends to spread rapidly?

    <p>Choriocarcinoma</p> Signup and view all the answers

    Which germ layers do testicular tumors derive from?

    <p>Endoderm, mesoderm, ectoderm</p> Signup and view all the answers

    What is the primary management approach for testicular tumors?

    <p>Orchiectomy</p> Signup and view all the answers

    What is the characteristic clinical presentation of testicular tumors?

    <p>Painless swelling or nodule in the testis</p> Signup and view all the answers

    What is the most common solid malignant tumor in men aged 30 to 34 years?

    <p>Seminoma</p> Signup and view all the answers

    Which factor significantly increases the risk of testicular cancer?

    <p>Having a first-degree relative with testicular cancer</p> Signup and view all the answers

    What is the primary cause of torsion, a urological emergency?

    <p>Twisting of the testicular venous drainage</p> Signup and view all the answers

    Which genetic abnormality increases the risk of developing testicular cancer?

    <p>Klinefelter syndrome</p> Signup and view all the answers

    What is the most common cause of testicular cancer in men aged 30 to 30 years?

    <p>Cryptorchidism</p> Signup and view all the answers

    What is the primary management approach for preventing the risk of torsion in the contralateral testis?

    <p>Fixation of the affected testis</p> Signup and view all the answers

    Study Notes

    Testicular Infections, Torsion, and Cancer Overview

    • Acute epididymo-orchitis presents with pain and swollen epididymis, caused by inflammation and neutrophil predominance
    • Management involves culture and sensitivity testing, raised C-Reactive Protein, ultrasound scans, and treatment with antibiotics, pain relief, and scrotal elevation
    • Chronic cases may require inpatient care and can lead to scarring and sterility
    • Torsion is a urological emergency resulting from twisting of the spermatic cord, leading to testicular infarction
    • Torsion presents with sudden testicular pain and must be "untwisted" within 6 hours to preserve testis viability
    • Testicular cancer is the most common solid malignant tumor in men aged 30-34, with a higher incidence in Caucasian men
    • Causes of testicular cancer include cryptorchidism, previous testicular cancer, genetic abnormalities, family history, infertility, and exposure to estrogen
    • Germ cell tumors, including seminomatous and non-seminomatous types, account for over 90% of testicular cancers
    • Seminomas grow slowly and are classified into classical and spermatocytic subtypes, affecting different age groups
    • Non-seminomatous germ cell tumors typically occur in men in their late teens and early 30s and include embryonal carcinoma, yolk sac tumor, choriocarcinoma, and teratoma
    • Each type of non-seminomatous germ cell tumor has distinct characteristics, growth patterns, and prognosis
    • Teratomas, derived from 3 germ cell layers, can be mature or immature, with varying potential for spreading and recurrence

    Pathological Conditions of the Testes and Testicular Cancer

    • A 41-year-old man's testes showed severe inflammation due to complications of enterocolitis and abscess formation, leading to testis removal.
    • Torsion, a urological emergency, results from twisting of the testicular venous drainage and causes sudden testicular pain.
    • Delayed treatment of torsion can lead to testicular infection and necrosis, requiring surgical intervention within 6 hours for viability.
    • Torsion management includes fixation of the affected testis and preventive measures for the contralateral testis to reduce the risk of torsion.
    • A 74-year-old man experienced testicular pain following drainage of a hydrocele, a collection of fluids around the testes, leading to a differential diagnosis of epididymitis.
    • Antibiotic treatment for the 74-year-old man's condition failed, and subsequent examination revealed a necrotic testis with hemorrhagic appearance and infiltrates.
    • Testicular cancer is the most common solid malignant tumor in men aged 30 to 30 years, with a higher incidence in Caucasian men than in black men.
    • Testicular cancer accounts for less than 1% of new cancers in the UK, with a 28% increase in incidence since the early 1990s.
    • Causes of testicular cancer include patient-related factors such as cryptorchidism, previous testicular cancer history, and genetic abnormalities like Klinefelter syndrome and Down's syndrome.
    • Patients with cryptorchidism and intra-abdominal testes have a significantly higher risk of testicular cancer compared to those with normal testicular anatomy.
    • Environmental factors play a minimal role in the development of testicular cancer, with patient-related factors being the primary contributors.
    • Genetic abnormalities, such as Klinefelter syndrome and Down's syndrome, increase the risk of developing testicular cancer.

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    Description

    Test your knowledge of testicular infections, torsion, and cancer with this overview quiz. Explore key points such as symptoms, management, and risk factors for conditions like epididymo-orchitis, testicular torsion, and various types of testicular cancer.

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