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KAPLAN Male Path

KAPLAN

QuestionAnswer
1. Penis Malformations 2. associated with undescended testes 3. increased risk of urinary tract infections (UTIs) and infertility Hypospadias and Epispadias
urethral opening on the ventral surface of the penis Hypospadias
urethral opening on the dorsal surface of the penis Epispadias
Balanitis/balanoposthitis inflammation of the glans penis
Causes of Balanitis/balanoposthitis poor hygiene and lack of circumcision
Penile fibromatosis resulting in curvature of the penis Peyronie disease
a. Warty, cauliflower-likegrowth b. Human papilloma virus (HPV) serotypes 6 and 11 Condyloma acuminatum
a. Uncommon in the United States b. Increased risk in uncircumcised males c. Human papilloma virus (HPV) serotypes 16 and 18 d. Precursors: Bowen disease,bowenoid papulosis, erythroplasia of Queyrat Squamous cell carcinoma (SCC)
a. Dilated vein within the spermatic cord b. May cause infertility Testes Varicocele
fluid within the tunica vaginalis Hydrocele
dilated efferent duct in the epididymus containing sperm Spermatocele
i. Age <35: Neisseria gonorrhoeae and Chlamydia trachomatis ii. Age >35: Escherichia coli and Pseudomonas Acute Epididymitis
Chronic epididymitis TB
Orchitis viral-mumps
a. Twisting of the spermatic cord b. May be associated with physical activity or trauma c. Painful hemorrhagic infarction Testicular torsion
1. Clinical presentation a. Firm, painless testicular mass b. Nonseminomatous tumors may present with widespread metastasis. Testicular Cancer
Risk factors a. Cryptorchidism: (5-10 times increased risk!) b. Testicular dysgenesis (testicular feminization and Klinefelter syndrome) c. Caucasians> African Americans d. Family history Testicular Cancer
Diagnosis a. Ultrasound: hypoechoic intratesticular mass b. Tumor marker studies c. Radical orchiectomy d. Staging:CXR and abdominal and/or chest CT Testicular Cancer
1. Most common germ-cell tumor in adults age 15-35 ii. Gross: large, gray-tan, bulky masses Seminoma
Micro . Polygonal germ cellswith clear cytoplasm and round nuclei . Arranged in lobules, which are separated by fibrous septae . Lymphocytes,granulomas, and giant cells may be seen Seminoma
Tumor marker: placental alkaline phosphatase (PLAP) v. Treatment: chemo and radiosensitive vi. Prognosis: excellent;early stage 95% cure Seminoma
Variant of seminoma spermatocytic seminoma
spermatocytic seminoma older men, excellent prognosis
i. Age 20s-40s ii. Gross: bulky masses with hemorrhage and necrosis iii. Micro: large primitive cells iv. Tumor markers: nonspecific, may have alpha-fetoprotein (AFP) and/or beta human chorionic gonadotropin (j3-hCG) v. More aggressivethen seminoma Embryonal carcinoma
Highly malignant with widespread metastasis ii. Gross: often small primaries with extensivehemorrhage and necrosis iii. Micro: proliferation of syncytiotrophoblasts and cytotrophoblasts iv. Tumor marker: B-hCG v. Hematogenous spread to lungs and live Choriocarcinoma
i. Most common germ-cell tumor in children ii. Good prognosis in children iii. In adults, it is often mixed with other components iv. Micro: Schiller-Duval bodies v. Tumor marker: alpha-fetoprotein (AFP Yolksac tumor (endodermal sinus tumor)
Created by: ychou