α-FP and/or β-hCG are elevated in approximately 80% to 85% of patients with non-seminomatous germ cell tumors
β-hCG increases in either seminoma or non-seminoma
LDH increases in 30% to 80% of pure seminoma patients and in 60% of non-seminoma patients
high levels of α-FP might induce nipple tenderness or gynecomastia
D. high levels of α-FP might induce nipple tenderness or gynecomastia
over 80%
over 85%
over 90 %
over 95 %
patients in whom retroperitoneal LN dissection (RPLND) reveals viable cancer cells after chemotherapy, subsequent chemotherapy is recommended
surgical resection is recommended for patients with residual disease after chemotherapy
open nerve-sparing RPLND might lead to premature ejaculation
in non-seminoma patients stage I-A, I-B, 1S on long-term surveillance, relapses are expected in 80% of cases within the first year after orchiectomy
rhabdomyosarcoma
liposarcoma
sarcomatoid tumor
angiosarcoma
yolk cell tumors
choriocarcinomas
embryonal carcinomas
pure seminomas
high levels of α-FP are found only in non-seminomas
high levels of α-FP may result from marijuana use
β-hCG levels above 10,000 mIU/mL are seen only in germ cell tumors and hepatocellular carcinoma
LDH is a useful marker for surveillance after tumor extirpation
should be suspected in any patient with a very high hCG level on diagnosis
the commonest subtype that causes brain metastases is choriocarcinoma
these patients should receive 4 cycles of bleomycin-etoposide-cisplatin as first-line chemotherapy
early initiation of chemotherapy ensures a good prognosis
in pure seminoma α-FP is normal
if syncytiotrophoblastic giant cells are present, β-hCG may be elevated
spermatocytic seminomas rarely metastasize without sarcomatous differentiation
pure seminoma constitutes approximately 90% of pure germ cell tumors
there is no clinical distinction between mature and immature teratoma
has no biological markers
is sensitive to chemotherapy
when large in size can be infiltrative and difficult to resect
left testicular tumors spread to the periaortic lymph nodes
right testicular tumors spread to the interaortocaval lymph nodes
the fashion of further spread in the retroperitoneum is from right to left
all of the above
environmental conditions exposing the testes to high temperature
47XXY genotype
prior testicular cancers
cryptorchidism
unilateral hydrocele
dull ache or heavy sensation in the lower abdomen
painless swelling or a nodule in the testicle
incidental finding on scrotal ultrasonography
lymphoma
spermatocytic seminoma
adenocarcinoma
cystadenoma
elevation of only α-FP indicates pure non-seminoma
elevation of α-FP might occur in chronic liver disease, hepatitis, and alcohol abuse
elevation of LDH indicates tumor burden and growth rate
elevation of β-hCG above 10,000 mIU/mL is seen only in germ cell tumors
3 months
3 spermatogenic cycles
3 yrs.
damage is permanent
polyembryoma
teratoma
embryonal carcinoma
mixed germ cell tumor
evaluates post chemotherapy residual masses in pure seminoma cases
helps stage non-seminomatous germ cell tumors
all of the above
used for active surveillance in non-operable cases
greater than 90%
lesser than 40%
greater than 70%
lesser than 20%
fossa navicularis
bulbomembranous urethra
prostatic urethra
external urethral meatus
rhabdomyosarcoma
liposarcoma
sarcomatoid tumor
angiosarcoma
epididymo-orchitis
indirect inguinal hernia
testicular microlithiasis
syphilitic gumma
active surveillance is recommended for patients with horseshoe kidney
adjuvant chemotherapy with a single dose of carboplatin is recommended as an alternative to radiation therapy
the number of positive nodes dissected dictates the number of chemotherapy cycles to be given
cure is possible after radical orchiectomy alone
undergo laparoscopic lymph node sampling
receive induction chemotherapy
undergo extensive retroperitoneal lymph node dissection
go for palliative therapy
in a patient with a history of GCTs, the finding of testicular microlithiasis on ultrasonography poses a higher risk of intratubular germ cell neoplasia
occur bilaterally approximately 2% of cases
are extragonadal in 1 - 5%
are more likely to contain embryonal tumor cells than tumors arising in the testis
pure embryonal carcinoma may increase serum α-FP and hCG levels
pure seminoma increases serum hCG levels in 15% of cases but not α-FP
typically, endodermal sinus tumors dont increase any tumor marker
pure choriocarcinoma is associated with high hCG levels but not α-FP
60%
70%
80%
90%
adult choriocarcinoma arise from ITGCN
spermatocytic seminoma arises from ITGCN
typically, pediatric germ cell tumors (GCT) do not arise from ITGCN
ITGCN is the common precursor for most of adult male GCT
peripheral neuropathy
renal failure
Raynaud phenomenon
hypogonadism
yolk cell tumors
spermatocytic seminoma
choriocarcinoma
embryonal carcinoma
is considered based on a histologic evidence
should not be performed through a scrotal incision
preoperative biopsy is required for histologic examination
entails early clamping of the cord at the external inguinal ring level
stem from the periphery of the testis
no non-pulmonary visceral metastases
normal α-FP, β-hCG, and LDH markers
all of the above