spinal shock
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a 25 year-old man presents with a complaint of testicular enlargement. examination reveals a hard nodule on the left testicle,2cm in diameter orchiectomy is diagnostic of testicular cancer.
A. from what cellular element of the testes does generally testecula ca arise what is the normal development of these cells
B. in addition to the testes where else might testicular cancer arise?whats the explanation for this distribution.
C. what serum markers might be monitored to evaluate diease progression and response therapy?
EXPLAIN PLEASE
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| GOGETA
I'm Dr. GOGETA
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Very good concept you ALL MUST know this
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| maoudoody
Forum Guru
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well 95% of testicular cancers arise from the germ cells
serum markers acoording to the type of the tumour range between 2 markers: fetoprotein and hcg
as regard b: where else testicular cancers can develop?
dont know
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| Tiff
Forum Guru
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Well, there are 3 types of testicular neoplasms. This is an extensive topic as there are so many testicular tumors. 1) Germ Cell (95% of cases are germ cell) 2) Stromal/Sex Cord 3) Lymphoma
I'll just mention the most common in each class.
GERM CELL
Seminomas are the most common cancer of this class. A) As in the name of its class, they are derived from germ cell. B) Tumor usually doesn't invade the tunica albuginea but can extend to the spermatic cord, epididymis, and scrotum. C) These will stain for placental Alkaline Phosphatase (A small percentage of these will have syncitial cells that will allow hCG to be detected). Others in this class: Spermatacytic seminoma, Embryonal carcinoma (hCG or AFP), Yolk Sac (AFP), Choriocarcinoma (hCG), Teratoma, & Mixed tumors (most have AFP & hCG)
STROMAL/SEX CORD
Leydig Cell tumors (which is what is most likely in this case) - A) derived from stroma. These are the leydig interstitial cells of the testicle B) These are usually smaller (less than 5 cm) so there's less chance of it extending anywhere else. C) This is detected by ultrasound. Most cases are benign (extratesticular), However if the ultrasound detects that the tumor is intratesticular then that is usually indicative of a malignancy (about 15% of cases). Others in this class: Sertoli cell (most are benign; 10% are malignant)
TESTICULAR LYMPHOMA
A) Diffuse large cell lymphoma - usually detected in the testes after dissemintated disease has occured. B) It's not a primary tumor of the testes but can presents as a testicular mass as it's only sign/symptom. Unfortunately disseminated disease has already occured.
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| spinal shock
Forum Senior
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excellent exp tiff you are right
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