1 / 27

NON-GERM CELL TUMORS

NON-GERM CELL TUMORS. Leydig Cell Tumors Sertoli Cell Tumors Gonadoblastomas. NON-GERM CELL TUMORS. Leydig Cell Tumors Sertoli Cell Tumors Gonadoblastomas. LEYDIG CELL TUMORS. Epidemiology and Pathology Most common non-germ cell tumor (1–3% of all testicular tumors)

rusty
Download Presentation

NON-GERM CELL TUMORS

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. NON-GERM CELL TUMORS Leydig Cell Tumors Sertoli Cell Tumors Gonadoblastomas

  2. NON-GERM CELL TUMORS Leydig Cell Tumors Sertoli Cell Tumors Gonadoblastomas

  3. LEYDIG CELL TUMORS Epidemiology and Pathology Most common non-germ cell tumor (1–3% of all testiculartumors) Bimodal age distribution (5-9; 25-35) 25% occurs in childhood No association w/ cryptorchidism unlike germ cell tumor

  4. Gross Pathology Pathologic examination reveals a small, yellow, well- circumscribed lesion devoid of hemorrhage or necrosis.

  5. Histopathology hexagonal; granular, eosinophilic cytoplasm w/ lipid vacuoles; Reinke crystals (fusiformcytoplasmic inclusions; pathognomonic)

  6. Clinical Findings Virilization(prepubertal)  tumors are benign Asymptomatic (adults); 20-25% w/ gynecomastia 10% tumors in adults are malignant Increased serum and urinary 17-ketosteroids and estrogens

  7. Treatment and Prognosis Radical orchiectomy- initial treatment Clinical staging is similar to that for germ celltumors levels of the 17-ketosteroids distinguishing between benign and malignant lesions Elevations of 10–30 times normal are typical of malignancy. RPLND is recommended for malignant lesions Prognosis is excellent for benign lesions Poor for patients with disseminated disease.

  8. NON-GERM CELL TUMORS Leydig Cell Tumors Sertoli Cell Tumors Gonadoblastomas

  9. SERTOLI CELL TUMORS Epidemiology and Pathology Rare (less than 1% of all testicular tumors) Bimodal age distribution (<1; 20-45) 10% are malignant

  10. Histopathology Gross: yellow or gray-white w/ cystic components; benign: well-circumscribed; malignant: ill-defined borders Microscopic: epithelial and stromal components; large nucleus; solitary nucleolus; vacuolated cytoplasm

  11. Clinical Findings Testicular mass- most common presentation Virilization (children) Gynecomastia (30% in adults) Treatment Radical orchiectomy- initial procedure of choice Malignancy: RPLND is indicated

  12. NON-GERM CELL TUMORS Leydig Cell Tumors Sertoli Cell Tumors Gonadoblastomas

  13. GONADOBLASTOMAS Epidemiology 0.5% of all testicular Almost exclusively seen in patients w/ gonadaldysgenesis <30 y/o (age distribution ranges from infancy to beyond 70years)

  14. Histopathology • Gross examination reveals a yellow or gray-whitelesion that can vary in size from microscopic to greaterthan 20 cm and may exhibit calcifications. • Microscopically, 3 cell types are seen: Sertoli cells, interstitial cells,and germ cells.

  15. Sagittal US – well circumscribed heterogenous echotexture

  16. Clinical Findings 4/5 of patients with gonadoblastomas are pheno- typicfemales Males typically have cryptorchidism or hypospadias. Treatment and Prognosis Radical orchiectomy In the presence of gonadaldysgenesis, a contralateralgonadectomyis recommended because the tumor tendsto be bilateral in 50% of case Excellent prognosis

  17. Germ Cell Tumors Non- Germ Cell Tumors Secondary Tumors

  18. SECONDARY TUMORS Lymphoma Leukemic infiltration Metastatic

  19. SECONDARY TUMORS Lymphoma Leukemic infiltration Metastatic

  20. LYMPHOMA Epidemiology and Pathology Most common tumor in a patient >50 y/o Most common secondary neoplasm (5% of all testicular tumors) Seen in 3 clinical settings Late manifestation of widespread lymphoma Initial presentation of clinically occult disease Primary extranodaldisease

  21. Histopathology • Gross: bulging, gray or pink, ill-defined margins; • hemorrhage & necrosis are common • Microscopic: diffuse histiocytic lymphoma

  22. Clinical Findings Painless enlargement of testis Bilateral in 50%; asynchronous Treatment and Prognosis FNA: patientswith a known or suspected diagnosis of lymphoma Radical orchiectomy is reserved for those with suspectedprimary lymphoma of the testicle Further staging andtreatment should be handled in conjunction with themedical oncologist Prognosis related to stage Adjuvant chemotherapy for primary testicular lymphoma: 93% survival rate

  23. SECONDARY TUMORS Lymphoma Leukemic infiltration Metastatic

  24. LEUKEMIC INFILTRATION Testis: relapse site for children w/ ALL Bilateral (50% of cases) Testis biopsy rather than orchiectomy is the diagnostic procedure of choice Bilateral irradiation (20Gy) & adjuvant chemotherapy- treatment of choice Prognosis remains guarded.

  25. SECONDARY TUMORS Lymphoma Leukemic infiltration Metastatic

  26. METASTATIC TUMORS Metastasis to the testis is rare Prostate: most common primary site Other sites: lung, GI tract, melanoma, kidney Pathology: neoplastic cells in the interstitiumw/ relative sparing of the seminiferoustubules

  27. RADICAL ORCHIECTOMY Orchiectomy - surgical removal of one or both testes

More Related