Male Genital System Ia

• An abnormal dorsal opening of the urethra is a epispadias
• An abnormal ventral opening of the urethra is hypospadias.
• Verrucous Carcinoma has no metastatic potential - low grade variant of SCC & locally invasive
• Small spermatic tubules are associated with testicular atrophy (reflect decreased size & function of testes)
• Pseudomonas & E.coli cause acute epididymitis in older men
• The characteristic microscopic finding in tuberculous epididymo - orchitis is granulomatous inflammation with caseous necrosis
• Mumps Orchitis is characterised by oedematous & congested testes
• Embryonal Carcinomas typically occurs between 20 - 30
• Seminomas are associated with the presence of syncytiotrophoblastic giant cells in 15% of cases
• AFP is elevated in patients with yolk sac tumours
• Choriocarcinomas have 100 % elevation of hCG in patients
• Yolk Sac Tumours are characterised by the presence of Schiller - Durall bodies
• Seminomas have a peak incidence between 40 - 50
• Candida Albicans, anaerobic and pyogenic bacteria are commonly associated with balantis & balanoposthitis
• Scarring of the prepuce can develop from balanoposthitis leading to phimosis
• Verrucous carcinoma has papillary architecture & no atypia
• Verrucous carcinoma has a characteristic feature of bulbous mucin borders
• The main causes of hydrocele is neighbouring infections & tumours
• Teratomas are usually benign pre-puberty & malignant post - puberty
• The characteristic feature of Bowen Disease is large pale keratinocytes with abundant ground cytoplasm called pagetoid cells
• The characteristic finding of Leydig cell tumours is reinke crystals
• Seminomas are grey - white lesions with a lobular pattern
• Seminomas have a presence of syncytiotrophoblastic giant cells in 15% of cases; Immunohistochemistry: β-hCG [+]
• The pathogenesis of testicular neoplasms are Intratubular Germ Cell Neoplasia (IGCN) = in situ lesion of Germ Cell Tumours
• Spermatocytic seminomas have no association with IGCN & metastatic potential
• Yolk Salk Tumours are the most common primary testicular neoplasm in children
• Yolk Sac Tumours have identification of PAS positive eosinophilic hyaline globules; Immunopositivity for α1 - antitrypsin and AFP
• Choriocarcinomas

  Microscopic Findings:

  • Sheets of small cuboidal cells, admixed with cytotrophoblastn and syncytiotrophoblast-like cells

  • Immunohistochemistry: HCG (+) in syncytiotrophoblast-like cells
• Clinical Features:

  • Painless testicular mass

  • Seminomas:

  • Often, remain confined to the testis

  • Metastases in the iliac and para-aortic lymph nodes

  • Non-seminomatous tumours:

  • Early metastases, by lymphatic and haematogenous routes

  •Haematogenous metastases = Liver and lung
• Prognosis of Testicular Neoplasms:

  • Seminoma: >95% of patients with early stage disease = Curable
  • Non - seminomatous tumours: ~90% of patients = Complete remission and cure, with aggressive chemotherapy
  • Pure Choriocarcinoma = Dismal prognosis