Podcast
Questions and Answers
What is the main gonad in the male reproductive system?
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?
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?
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?
What are the two components that make up the testis?
What type of cells are responsible for mechanical support and hormone production in the testis?
What type of cells are responsible for mechanical support and hormone production in the testis?
What is the name of the structure responsible for spermatogenesis?
What is the name of the structure responsible for spermatogenesis?
What is the main cell type in the seminiferous tubules?
What is the main cell type in the seminiferous tubules?
What are the undifferentiated germ cells that will mature into spermatozoa?
What are the undifferentiated germ cells that will mature into spermatozoa?
Testicular tumors are a common type of cancer.
Testicular tumors are a common type of cancer.
What is the most prevalent type of testicular tumor?
What is the most prevalent type of testicular tumor?
What are the main symptoms of a testicular tumor? (Select all that apply)
What are the main symptoms of a testicular tumor? (Select all that apply)
Chemotherapy has proven to be a very effective treatment for testicular tumors.
Chemotherapy has proven to be a very effective treatment for testicular tumors.
What percentage of testicular tumors are germ cell tumors?
What percentage of testicular tumors are germ cell tumors?
What type of tumor is more common after the age of 50?
What type of tumor is more common after the age of 50?
What are the two main categories of germ cell tumors?
What are the two main categories of germ cell tumors?
When do seminomas peak during adulthood?
When do seminomas peak during adulthood?
When do non seminomatous tumors peak during adulthood?
When do non seminomatous tumors peak during adulthood?
What is the estimated increased risk of developing a testicular germ cell tumor if you have cryptorchidism?
What is the estimated increased risk of developing a testicular germ cell tumor if you have cryptorchidism?
What is the estimated increased risk of developing a testicular germ cell tumor if you have a family history of the disease?
What is the estimated increased risk of developing a testicular germ cell tumor if you have a family history of the disease?
What is the estimated increased risk of developing a testicular germ cell tumor if you have gonadal dysgenesis with a Y chromosome?
What is the estimated increased risk of developing a testicular germ cell tumor if you have gonadal dysgenesis with a Y chromosome?
What is the estimated increased risk of developing a testicular germ cell tumor if you have androgen insensitivity syndrome?
What is the estimated increased risk of developing a testicular germ cell tumor if you have androgen insensitivity syndrome?
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?
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?
What are the primary functions of the yolk sac? (Select all that apply)
What are the primary functions of the yolk sac? (Select all that apply)
What is the name of the specialized organ that forms later in pregnancy to establish a connection between the mother and the fetus?
What is the name of the specialized organ that forms later in pregnancy to establish a connection between the mother and the fetus?
What are the functions of the placenta? (Select all that apply)
What are the functions of the placenta? (Select all that apply)
What are the two main categories of germ cell tumor classification based on origin?
What are the two main categories of germ cell tumor classification based on origin?
What type of germ cell tumor can only be differentiated under the microscope? (Select all that apply)
What type of germ cell tumor can only be differentiated under the microscope? (Select all that apply)
What is the name of the marker found in the nucleus that is used to recognize GCNIS and non-GCNIS related tumors?
What is the name of the marker found in the nucleus that is used to recognize GCNIS and non-GCNIS related tumors?
What is the name of the marker found on cellular membranes that is used to recognize GCNIS and non-GCNIS related tumors?
What is the name of the marker found on cellular membranes that is used to recognize GCNIS and non-GCNIS related tumors?
What two types of tumors are crucial to distinguish using these markers?
What two types of tumors are crucial to distinguish using these markers?
Seminomas are immunoreactive to OCT4 and c-KIT, while embryonal carcinomas are only reactive to OCT4.
Seminomas are immunoreactive to OCT4 and c-KIT, while embryonal carcinomas are only reactive to OCT4.
What type of cells express OCT4 and c-KIT during normal maturation?
What type of cells express OCT4 and c-KIT during normal maturation?
Carcinogenic outcomes can arise if gene expression of OCT4 and c-KIT is suppressed.
Carcinogenic outcomes can arise if gene expression of OCT4 and c-KIT is suppressed.
What are the risk factors linked to the failure of the mechanism that suppresses the gene expression of OCT4 and c-KIT?
What are the risk factors linked to the failure of the mechanism that suppresses the gene expression of OCT4 and c-KIT?
Studies have shown that 80% of patients who have germ cell neoplasia will develop invasive tumors after 7 years.
Studies have shown that 80% of patients who have germ cell neoplasia will develop invasive tumors after 7 years.
What is the most likely risk factor for developing testicular carcinomas?
What is the most likely risk factor for developing testicular carcinomas?
What is the most common germ cell tumor?
What is the most common germ cell tumor?
What is the specific immunohistochemical serological marker for seminomas?
What is the specific immunohistochemical serological marker for seminomas?
Seminomas are typically pure and not mixed with other types of tumors.
Seminomas are typically pure and not mixed with other types of tumors.
What is the gross appearance of seminomas?
What is the gross appearance of seminomas?
What is the microscopic appearance of seminomas?
What is the microscopic appearance of seminomas?
What are the two elements that seminomas are composed of?
What are the two elements that seminomas are composed of?
What is the name of the second most common germ cell tumor?
What is the name of the second most common germ cell tumor?
Embryonal carcinoma is rarely found in a pure form.
Embryonal carcinoma is rarely found in a pure form.
What is the gross appearance of embryonal carcinoma?
What is the gross appearance of embryonal carcinoma?
What is the microscopic appearance of embryonal carcinoma?
What is the microscopic appearance of embryonal carcinoma?
Seminoma and embryonal carcinoma do not have specific markers.
Seminoma and embryonal carcinoma do not have specific markers.
Yolk sac tumors are always pure.
Yolk sac tumors are always pure.
Prepubertal yolk sac tumors are always pure.
Prepubertal yolk sac tumors are always pure.
What is the gross appearance of yolk sac tumors?
What is the gross appearance of yolk sac tumors?
What are the two main variations of yolk sac tumors in the microscopic appearance?
What are the two main variations of yolk sac tumors in the microscopic appearance?
Prepubertal and postpubertal yolk sac tumors appear the same morphologically.
Prepubertal and postpubertal yolk sac tumors appear the same morphologically.
What is the name of the fourth most common germ cell tumor?
What is the name of the fourth most common germ cell tumor?
Choriocarcinoma is often found in a pure form in adults.
Choriocarcinoma is often found in a pure form in adults.
What hormone is present in high levels with choriocarcinoma?
What hormone is present in high levels with choriocarcinoma?
What is the name of the syndrome associated with choriocarcinoma?
What is the name of the syndrome associated with choriocarcinoma?
What is the gross appearance of choriocarcinoma?
What is the gross appearance of choriocarcinoma?
What is the microscopic appearance of choriocarcinoma?
What is the microscopic appearance of choriocarcinoma?
Seminomas with syncytiotrophoblastic elements are considered pure tumors.
Seminomas with syncytiotrophoblastic elements are considered pure tumors.
Teratomas are always benign.
Teratomas are always benign.
Prepubertal teratomas are benign.
Prepubertal teratomas are benign.
Postpubertal teratomas are usually benign.
Postpubertal teratomas are usually benign.
Most non-seminomatous tumors are mixed.
Most non-seminomatous tumors are mixed.
What are the most common combinations of mixed germ cell tumors?
What are the most common combinations of mixed germ cell tumors?
What is the name of the stage that is not determined by size but by the structures that are invaded?
What is the name of the stage that is not determined by size but by the structures that are invaded?
What are the structures that are invaded in the pT2 stage?
What are the structures that are invaded in the pT2 stage?
What factors are prognostic for germ cell tumors?
What factors are prognostic for germ cell tumors?
What type of tumor does not have a specific marker?
What type of tumor does not have a specific marker?
Seminoma is the only cancer that comes in a pure form.
Seminoma is the only cancer that comes in a pure form.
What is the average age of the affected group of spermatocytic tumors?
What is the average age of the affected group of spermatocytic tumors?
Spermatocytic tumors are usually benign.
Spermatocytic tumors are usually benign.
What percentage of testicular tumors are sex cord stromal tumors that are non-GCT?
What percentage of testicular tumors are sex cord stromal tumors that are non-GCT?
What is the most common sex cord stromal tumor?
What is the most common sex cord stromal tumor?
Leydig cell tumors are more common in children than adults.
Leydig cell tumors are more common in children than adults.
The most common germ cell tumor in adults is also the most common cause of what in 30% of patients?
The most common germ cell tumor in adults is also the most common cause of what in 30% of patients?
What is the gross appearance of Leydig cell tumors?
What is the gross appearance of Leydig cell tumors?
What makes the histological of Leydig cells different?
What makes the histological of Leydig cells different?
What does the S stand for in the staging system for testicular tumors?
What does the S stand for in the staging system for testicular tumors?
What is the range for the serum marker concentration?
What is the range for the serum marker concentration?
The higher the serum marker concentration, the lower the metastasis.
The higher the serum marker concentration, the lower the metastasis.
You are a doctor and a patient has a unilateral testicular mass. What is the most likely diagnosis?
You are a doctor and a patient has a unilateral testicular mass. What is the most likely diagnosis?
What is the most common germ cell tumor in adults?
What is the most common germ cell tumor in adults?
What's the most likely risk factor for testicular germ cell carcinomas?
What's the most likely risk factor for testicular germ cell carcinomas?
Which of these is considered the most common germ cell tumor?
Which of these is considered the most common germ cell tumor?
Which of the following tumors is known to produce high levels of hCG?
Which of the following tumors is known to produce high levels of hCG?
The presence of syncytiotrophoblasts in a seminoma has a significant impact on the prognosis of the tumor.
The presence of syncytiotrophoblasts in a seminoma has a significant impact on the prognosis of the tumor.
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?
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?
What does the "S" in the staging system for testicular tumors stand for?
What does the "S" in the staging system for testicular tumors stand for?
What is the most common type of germ cell tumor after the age of 50?
What is the most common type of germ cell tumor after the age of 50?
Match the following germ cell tumors with their primary marker:
Match the following germ cell tumors with their primary marker:
Flashcards
Tunica Albuginea
Tunica Albuginea
The outermost layer of the testis, a tough fibrous capsule that surrounds the seminiferous tubules.
Tunica Vaginalis
Tunica Vaginalis
A double-layered membrane covering the testis, the outer layer is parietal and the inner is visceral.
Parenchymal Component
Parenchymal Component
The functional part of the testis that contains the seminiferous tubules where sperm production occurs. Comprised of Sertoli cells and germ cells.
Stromal Component
Stromal Component
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Stromal Tumor
Stromal Tumor
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Sertoli Cells
Sertoli Cells
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Spermatogonia
Spermatogonia
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Testicular Cancer
Testicular Cancer
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Germ Cell Tumor
Germ Cell Tumor
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Seminoma
Seminoma
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Non-Seminomatous Germ Cell Tumors
Non-Seminomatous Germ Cell Tumors
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Embryonal Carcinoma
Embryonal Carcinoma
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Yolk Sac Tumor
Yolk Sac Tumor
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Choriocarcinoma
Choriocarcinoma
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Teratoma
Teratoma
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Germ Cell Neoplasia In Situ (GCNIS)
Germ Cell Neoplasia In Situ (GCNIS)
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Cryptorchidism
Cryptorchidism
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Gonadal Dysgenesis
Gonadal Dysgenesis
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Androgen Insensitivity Syndrome
Androgen Insensitivity Syndrome
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Alpha-Fetoprotein (AFP)
Alpha-Fetoprotein (AFP)
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Human Chorionic Gonadotropin (hCG)
Human Chorionic Gonadotropin (hCG)
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Sex Cord Stromal Tumor
Sex Cord Stromal Tumor
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Leydig Cell Tumor
Leydig Cell Tumor
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Gonadoblastoma
Gonadoblastoma
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Spermatocytic Tumor
Spermatocytic Tumor
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Testicular Cancer Staging System
Testicular Cancer Staging System
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pT2
pT2
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Lactate Dehydrogenase (LDH)
Lactate Dehydrogenase (LDH)
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Reinke Crystals
Reinke Crystals
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Testicular Torsion
Testicular Torsion
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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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