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TESTICULAR TUMORS - Coggle Diagram

- - - - SEMINOMA
        
        55%
        
        EXCELENT prognosis
        
        MALIGNANT
        
        Painless
        
        Homogeneous testicular alargement NO HEMORRHAGE OR NECROSIS
        
        NOT in infancy
        
        Histology: Large cells in lobules with watery (clear) cytoplasm and “fried egg” appearance (central nuclei)
        
        ↑↑ placental alkaline phosphatase (PLAP)
        
        Most common testicular tumor; resembles ovarian dysgerminoma
        
        Rare cases
        produce β- hCG
        
        Highly responsive to radiotherapy
        
        Metastasize late
      - NON-SEMINOMA
        
        45%
        
        Variable response
        Radiotx also Prognosis
        
        Metastasize later
        
        Teratoma
        
        Mature fetal tissue from 2
        or 3 embryonic layers
        
        ↑↑AFP or ↑↑ β-hCG
        
        MALIGNANT in males
        
        Benign in children and females
        
        Yolk sac tumor
        
        Also called
        endodermal
        sinus tumor
        
        ↑↑ AFP
        characteristically
        
        MALIGNANT: Resembles yolk sac
        elements→ Yellow, mucinous
        
        AGGRESSIVE
        
        Histology: Schiller-Duval bodies (glomerulus-like structures)
        
        1° tumor CHILDREN: < 3 years
        
        Embryonal
        carcinoma
        
        Aggressive →
        hematogenous spread
        
        Worse prognosis
        than seminoma
        
        MALIGNANT: Immature primitive cells→
        glandular/papillary morphology
        
        PAINFUL →Hemorrhagic mass + necrosis
        
        "PURE" form rare/ commonly mixed other types
        
        Metastases may exist
        
        PURE: ↑↑ AFP + ↑↑ β-hCG
        
        Mixed tumor: Normal AFP + ↑↑ β-hCG (Germ cells mixed, prognosis based on the worst component)
        
        Chemotherapy →makes differentiation
        into another type of germ cell tumor (TERATOMA)
        
        Choriocarcinoma
        
        Hematogenous
        metastases:
        
        To lungs & Brain
        
        MALIGNANT: Disordered syncytiotrophoblasts + cytotrophoblasts (placenta-like tissue, but villi are absent
        
        Can cause gynecomastia and hyperthyroidism (β subunit of hCG is similar to β subunit of TSH)
        
        β-hCG is characteristically elevated
- - - - Leydig cell tumor
        
        Mostly benign
        
        Histology: Reinke crystals (eosinophilic cytoplasmic inclusions)
        
        Produces androgens or estrogens→ precocious puberty in children & gynecomastia adults
        
        Golden brown color
      - Sertoli cell tumor
        
        Androblastoma
        
        Characterized by the formation of small tubules that resemble the normal structures found within the testicles
        
        Clinically silent
        
        Mostly benign
  - - - Often bilateral
        
        MALIGNANT
        
        AGGRESSIVE