USMLE - Reproduction Part 4
Cryptorchidism is the failure of one or both testes to descend into the scrotum, often seen in premature infants. It leads to impaired spermatogenesis due to higher abdominal temperatures but usually normal testosterone if unilateral. It is associated with an increased risk of germ cell tumors, and labs may show ↑ FSH, ↑ LH, ↓ inhibin B, and ↓ testosterone if bilateral.
Cryptorchidism
What is it?
Consequences
Associated with what?
What increases risk for it?
Labs
Undescended testis
Impaired spermatogenesis (b/c of temp) but normal testosterone
Risk of germ cell tumor
Prematurity
↑ FSH, LH and ↓ inhibin (and testosterone if bilateral)
Key Terms
Cryptorchidism
What is it?
Consequences
Associated with what?
What increases risk for it?
Labs
Undescended testis
Impaired spermatogenesis (b/c of temp) but normal testosterone
Risk of germ cell tumor
Prematurity
↑ FSH...
Varicocele
PathoPhys
Consequences
Location
Can lead to...
Gross
How is Diagnosis made?
Treatment
Dilated veins in Pampiniform plexus b/c of ↑ venous pressure
Most common cause of scrotal enlargement
More common on Left
Inferti...
Testicular Germ Cell Tumor
Frequency
Danger?
Can present as...
DDx
95% of all testicular tumors
Most often malignant
Can present as mixed germ cell tumor
Testicular mass that does not transillumin...
Seminoma
What kind of cancer?
Malignant?
Presentation
Epidemiology
Histo
Labs
Treatment
Prognosis
Testicular Germ Cell Tumor
Malignant
Painless homogenous testicular enlargement
Most common testicular tumor mostly affecting mal...
Yolk Sac (endodermal sinus) tumor in males
What kind of cancer?
Gross
Analog
Histo
Labs
Testicular Germ Cell Tumor
Yellow, Mucinous
Analogous to ovarian yolk sac tumor
Schiller-Duval Bodies resemble primitive glome...
Choriocarcinoma in males
What kind of cancer?
Danger?
Labs
What is it made of?
Metastasis?
Complications
Testicular Germ Cell Tumor
Malignant
Increased hCG
Syncuytiotrophoblastic and Cytotrophoblastic elements
Hematogenous me...
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| Term | Definition |
|---|---|
Cryptorchidism What is it? Consequences Associated with what? What increases risk for it? Labs | Undescended testis Impaired spermatogenesis (b/c of temp) but normal testosterone Risk of germ cell tumor Prematurity ↑ FSH, LH and ↓ inhibin (and testosterone if bilateral) |
Varicocele PathoPhys Consequences Location Can lead to... Gross How is Diagnosis made? Treatment | Dilated veins in Pampiniform plexus b/c of ↑ venous pressure Most common cause of scrotal enlargement More common on Left Infertility Bag of Worms appearance Diagnosed by US Varicocelectomy, Embolization |
Testicular Germ Cell Tumor Frequency Danger? Can present as... DDx | 95% of all testicular tumors Most often malignant Can present as mixed germ cell tumor Testicular mass that does not transilluminate |
Seminoma What kind of cancer? Malignant? Presentation Epidemiology Histo Labs Treatment Prognosis | Testicular Germ Cell Tumor Malignant Painless homogenous testicular enlargement Most common testicular tumor mostly affecting males 15-35 Large cells in lobules with watery cytoplasm and fried egg appearance Placental ALP Radiosensitive Late metastasis with excellent prognosis |
Yolk Sac (endodermal sinus) tumor in males What kind of cancer? Gross Analog Histo Labs | Testicular Germ Cell Tumor Yellow, Mucinous Analogous to ovarian yolk sac tumor Schiller-Duval Bodies resemble primitive glomeruli ↑ AFP |
Choriocarcinoma in males What kind of cancer? Danger? Labs What is it made of? Metastasis? Complications | Testicular Germ Cell Tumor Malignant Increased hCG Syncuytiotrophoblastic and Cytotrophoblastic elements Hematogenous mets to lungs Gynecomastia because of hCG |
Teratoma in male What kind of cancer? Malignant? Labs | Testicular Germ Cell Tumor |
Embryonal Carcinoma What kind of cancer? Danger? Presentation Prognosis Histo Pure? Labs | Testicular Germ Cell Tumor |
Testicular Non-Germ Cell Tumor | 5% of all testicular cancers | Mostly benign |
Leydig cell cancer What kind of cancer Histo What does it produce? Presentation Gross | Testicular non-Germ Cell Tumor Reinke Crystals Androgen producing Gynecomastia in men, precocious puberty in boys Golden Brown color |
Sertoli cell Cancer What kind of cancer Description Origin | Testicular non-Germ Cell Tumor Androblastoma From sex cord stroma |
Testicular Lymphoma What kind of cancer? Epidemiology Origin Course | Testicular non-Germ Cell Tumor Most common testicular caner in older men Arises from lymphoma metastases to testes Aggressive |
Tunica Vaginalis Lesions What is it? Presentation Types w/ causes | Lesions in the serous covering of testis |
Squamous Cell Carcinoma of the Penis | Asia, Africa, and South America | HPV and lack of circumcision |
Peyronie's Disease | Bent Penis due to acquired fibrous tissue formation |
Priapism | Painful sustained erection not associated with stimulation or desire |