Testis Tumors Overview
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Questions and Answers

What is the main gonad in the male reproductive system?

The testis

What is the name of the outer covering of the testis that is covered by peritoneum?

Tunica albuginea

What is the name of the structure that descends from the peritoneum and goes inside the inguinal canal during embryogenesis?

Wolffian ducts

What are the two components that make up the testis?

<p>Stromal and Parenchymal</p> Signup and view all the answers

What type of cells are responsible for mechanical support and hormone production in the testis?

<p>Leydig cells</p> Signup and view all the answers

What is the name of the structure responsible for spermatogenesis?

<p>Seminiferous tubules</p> Signup and view all the answers

What is the main cell type in the seminiferous tubules?

<p>Sertoli cells</p> Signup and view all the answers

What are the undifferentiated germ cells that will mature into spermatozoa?

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

Testicular tumors are a common type of cancer.

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

What is the most prevalent type of testicular tumor?

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

What are the main symptoms of a testicular tumor? (Select all that apply)

<p>Retroperitoneal masses</p> Signup and view all the answers

Chemotherapy has proven to be a very effective treatment for testicular tumors.

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

What percentage of testicular tumors are germ cell tumors?

<p>95%</p> Signup and view all the answers

What type of tumor is more common after the age of 50?

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

What are the two main categories of germ cell tumors?

<p>Seminomas and non-seminomatous tumors</p> Signup and view all the answers

When do seminomas peak during adulthood?

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

When do non seminomatous tumors peak during adulthood?

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

What is the estimated increased risk of developing a testicular germ cell tumor if you have cryptorchidism?

<p>3.5-5x</p> Signup and view all the answers

What is the estimated increased risk of developing a testicular germ cell tumor if you have a family history of the disease?

<p>3-10x</p> Signup and view all the answers

What is the estimated increased risk of developing a testicular germ cell tumor if you have gonadal dysgenesis with a Y chromosome?

<p>50x</p> Signup and view all the answers

What is the estimated increased risk of developing a testicular germ cell tumor if you have androgen insensitivity syndrome?

<p>15x</p> Signup and view all the answers

What is the name of the membranous structure that develops during early embryogenesis and plays a crucial role in the nutrition and development of the embryo?

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

What are the primary functions of the yolk sac? (Select all that apply)

<p>Providing initial nutrition before the placenta is fully functional</p> Signup and view all the answers

What is the name of the specialized organ that forms later in pregnancy to establish a connection between the mother and the fetus?

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

What are the functions of the placenta? (Select all that apply)

<p>Facilitates the exchange of oxygen, nutrients, and waste products between maternal and fetal blood</p> Signup and view all the answers

What are the two main categories of germ cell tumor classification based on origin?

<p>GCNIS-related tumors and non-GCNIS-related tumors</p> Signup and view all the answers

What type of germ cell tumor can only be differentiated under the microscope? (Select all that apply)

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

What is the name of the marker found in the nucleus that is used to recognize GCNIS and non-GCNIS related tumors?

<p>OCT4</p> Signup and view all the answers

What is the name of the marker found on cellular membranes that is used to recognize GCNIS and non-GCNIS related tumors?

<p>c-KIT</p> Signup and view all the answers

What two types of tumors are crucial to distinguish using these markers?

<p>Seminomas and embryonal carcinomas</p> Signup and view all the answers

Seminomas are immunoreactive to OCT4 and c-KIT, while embryonal carcinomas are only reactive to OCT4.

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

What type of cells express OCT4 and c-KIT during normal maturation?

<p>Primordial germ cells</p> Signup and view all the answers

Carcinogenic outcomes can arise if gene expression of OCT4 and c-KIT is suppressed.

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

What are the risk factors linked to the failure of the mechanism that suppresses the gene expression of OCT4 and c-KIT?

<p>All of the above</p> Signup and view all the answers

Studies have shown that 80% of patients who have germ cell neoplasia will develop invasive tumors after 7 years.

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

What is the most likely risk factor for developing testicular carcinomas?

<p>Gonadal dysgenesis</p> Signup and view all the answers

What is the most common germ cell tumor?

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

What is the specific immunohistochemical serological marker for seminomas?

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

Seminomas are typically pure and not mixed with other types of tumors.

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

What is the gross appearance of seminomas?

<p>Whitish appearance with clear demarcation, somewhat nodular, and can be seen bulging out.</p> Signup and view all the answers

What is the microscopic appearance of seminomas?

<p>Multinodular with a thin connective tissue layer corresponding to the compressed stromal tissue.</p> Signup and view all the answers

What are the two elements that seminomas are composed of?

<p>Neoplastic germ cells and lymphocytes</p> Signup and view all the answers

What is the name of the second most common germ cell tumor?

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

Embryonal carcinoma is rarely found in a pure form.

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

What is the gross appearance of embryonal carcinoma?

<p>Poorly circumscribed, gray-whitish coalition nodular mass, prominent areas of hemorrhage and necrosis</p> Signup and view all the answers

What is the microscopic appearance of embryonal carcinoma?

<p>Large cells with a prominent nucleus, suggesting it is not a seminoma</p> Signup and view all the answers

Seminoma and embryonal carcinoma do not have specific markers.

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

Yolk sac tumors are always pure.

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

Prepubertal yolk sac tumors are always pure.

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

What is the gross appearance of yolk sac tumors?

<p>Gray-whitish/yellowish appearance, often with a gelatinous, myxoid or mucoid surface.</p> Signup and view all the answers

What are the two main variations of yolk sac tumors in the microscopic appearance?

<p>Endodermal sinus-like structure and Microcystic appearance</p> Signup and view all the answers

Prepubertal and postpubertal yolk sac tumors appear the same morphologically.

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

What is the name of the fourth most common germ cell tumor?

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

Choriocarcinoma is often found in a pure form in adults.

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

What hormone is present in high levels with choriocarcinoma?

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

What is the name of the syndrome associated with choriocarcinoma?

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

What is the gross appearance of choriocarcinoma?

<p>Multinodular hemorrhagic lesions</p> Signup and view all the answers

What is the microscopic appearance of choriocarcinoma?

<p>Blood and multinucleated giant cells resembling placental cells</p> Signup and view all the answers

Seminomas with syncytiotrophoblastic elements are considered pure tumors.

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

Teratomas are always benign.

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

Prepubertal teratomas are benign.

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

Postpubertal teratomas are usually benign.

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

Most non-seminomatous tumors are mixed.

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

What are the most common combinations of mixed germ cell tumors?

<p>Embryonal carcinoma + teratoma, embryonal carcinoma + seminoma, and embryonal carcinoma + yolk sac tumor + teratoma</p> Signup and view all the answers

What is the name of the stage that is not determined by size but by the structures that are invaded?

<p>pT2</p> Signup and view all the answers

What are the structures that are invaded in the pT2 stage?

<p>Epididymis, hilar soft tissue tunica vaginalis, vascular/lymphatic structures</p> Signup and view all the answers

What factors are prognostic for germ cell tumors?

<p>Stage, margin status, pure or predominant choriocarcinoma, rete testis and hilar invasion, and advanced tumors</p> Signup and view all the answers

What type of tumor does not have a specific marker?

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

Seminoma is the only cancer that comes in a pure form.

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

What is the average age of the affected group of spermatocytic tumors?

<p>52 years</p> Signup and view all the answers

Spermatocytic tumors are usually benign.

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

What percentage of testicular tumors are sex cord stromal tumors that are non-GCT?

<p>5%</p> Signup and view all the answers

What is the most common sex cord stromal tumor?

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

Leydig cell tumors are more common in children than adults.

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

The most common germ cell tumor in adults is also the most common cause of what in 30% of patients?

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

What is the gross appearance of Leydig cell tumors?

<p>Yellow masses that resemble adrenal glands</p> Signup and view all the answers

What makes the histological of Leydig cells different?

<p>They produce Reinke crystals</p> Signup and view all the answers

What does the S stand for in the staging system for testicular tumors?

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

What is the range for the serum marker concentration?

<p>S0 to S3</p> Signup and view all the answers

The higher the serum marker concentration, the lower the metastasis.

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

You are a doctor and a patient has a unilateral testicular mass. What is the most likely diagnosis?

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

What is the most common germ cell tumor in adults?

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

What's the most likely risk factor for testicular germ cell carcinomas?

<p>Gonadal Dysgenesis</p> Signup and view all the answers

Which of these is considered the most common germ cell tumor?

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

Which of the following tumors is known to produce high levels of hCG?

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

The presence of syncytiotrophoblasts in a seminoma has a significant impact on the prognosis of the tumor.

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

What is the most likely diagnosis in a 37-year-old man presenting with bilateral breast enlargement, a firm right testis twice the size of the left testis, increased serum estrogen, and a 2-cm testicular mass with rod-shaped crystalloids of Reinke on electron microscopy?

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

What does the "S" in the staging system for testicular tumors stand for?

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

What is the most common type of germ cell tumor after the age of 50?

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

Match the following germ cell tumors with their primary marker:

<p>Seminoma = LDH Embryonal Carcinoma = OCT4 Yolk Sac Tumor = AFP Choriocarcinoma = hCG</p> Signup and view all the answers

Study Notes

Testis Tumors

  • The testis is a primary reproductive organ comprised of tubules.
  • The testis is surrounded by a tunica albuginea and covered by peritoneum.
  • During development, the gonads move from the peritoneum to the retroperitoneum, passing through the inguinal canal.
  • The tunica vaginalis is the mesothelium that lines the testis and scrotum. Staging for testicular tumors depends on whether the tumor infiltrates the tunica albuginea or tunica vaginalis.
  • The gonads are responsible for reproduction, featuring a stromal component for structural support and hormonal production and a parenchymal component for spermatogenesis.
  • Leydig cells are the primary stromal cells. Vimentin is a common marker for connective tissue.
  • Germ cell tumors are much more prevalent than stromal tumors.
  • Testicular tumors are rare and most common in individuals between puberty and young adulthood.
  • Germ cell tumors constitute about 95% of such tumors at this age group.
  • The most prevalent types are seminomas and non-seminomatous germ cell tumors.
  • Important diagnostic methods include immunochemistry, employing markers like OCT4 and c-KIT to distinguish GCNIS from non-GCNIS-related tumors.
  • Studies suggest that 80% of patients with germ cell neoplasia will progress to invasive tumors within 7 years.

Germ Cell Tumors

  • They are classified into seminomas and non-seminomas.
  • Seminomas peak in adulthood, while non-seminomas peak during adolescence.
  • Risk factors include cryptorchidism, a family history of testicular tumors, and conditions like gonadal dysgenesis and androgen insensitivity syndrome.
  • Choriocarcinoma produces human chorionic gonadotropin (hCG).
  • Yolk sac tumor produces alpha-fetoprotein (AFP).
  • Seminomas can produce hCG, but less than choriocarcinomas.
  • Teratomas can contain somatic cell types.
  • Embryonal carcinomas resemble embryonic stem cells.
  • Types of GCTs include seminoma, teratoma, embryonal carcinoma, yolk sac tumor (YST), and choriocarcinoma.
  • Teratomas are a mixed type of tumor that can contain a variety of tissue types.
  • Serum tumor markers are important for staging, and higher concentrations correlate with higher rates of metastasis.

Other Relevant Information

  • Important diagnostic methods include immunochemistry. Markers such as OCT4 and c-KIT are used to differentiate between different GCNISs and non-GCNIS-related tumors.
  • Studies point out that 80% of patients with germ cell neoplasia will progress to invasive tumors within 7 years.
  • Tumors are classified based on origin (GCNIS- or non-GCNIS-related) and morphology.
  • Morphologies are: Seminoma, Teratoma, Embryonal Carcinoma, Yolk Sac Tumor. Choriocarcinoma.
  • Mixed germ cell tumors frequently comprise Embryonal Ca + Teratoma, Embryonal Ca + Seminoma, Embryonal Ca + YST +Teratoma.
  • Staging is not solely determined by tumor size, but by the invaded structures (e.g., epididymis, hilar soft tissue, tunica vaginalis, vascular/lymphatic structures).
  • Stage, margin status, rete testis and hilar invasion, and number and size of metastases are prognostic factors.

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Pathology and Diagnostics - Testis Tumors PDF

Description

This quiz covers the essential aspects of testis tumors, including their anatomy, classification, and the developmental aspects of the testis. Learn about the different types of tumors and their prevalence, particularly in young adults. Gain a deeper understanding of the roles of various cells involved in tumor formation.

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