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  #1  
Old 07-23-2012
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Question Testicular cancer in a 42-year-old

A 42-year-old develops a painless mass in his left scrotal sac that was not present 3 months ago. Physical examination shows an enlarged testis which is firm. The right testis is normal. Laboratory studies show an absence of serum human chorionic gonadotropin (hCG) and α-fetoprotein (AFP). Histology of the tumor showed extensive lymphocytic infiltration. What kind of tumor is this most likely to be?

a) Choriocarcinoma
b) Lymphoma
c) Seminoma
d) Teratoma
e) Yolk sac tumor
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  #2  
Old 07-23-2012
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c - seminoma
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Old 07-23-2012
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Quote:
Originally Posted by Casandra View Post
A 42-year-old develops a painless mass in his left scrotal sac that was not present 3 months ago. Physical examination shows an enlarged testis which is firm. The right testis is normal. Laboratory studies show an absence of serum human chorionic gonadotropin (hCG) and α-fetoprotein (AFP). Histology of the tumor showed extensive lymphocytic infiltration. What kind of tumor is this most likely to be?

a) Choriocarcinoma
b) Lymphoma
c)Seminoma
d) Teratoma
e) Yolk sac tumor
Here tumor marker would be likely PAP(placental alkaline phosphatase)
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Old 07-23-2012
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ill go for testicular lymphoma....histology doesn't point towards seminoma

Most common testicular cancer in older men is metastatic lymphoma--pg 552 FA 2012
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Old 07-23-2012
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Guy's just 42 so probably not a lymphoma. I pick seminoma.
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Old 07-23-2012
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only AFP: mostly yolk sac tumor
only hCG: chorinocarninoma (most aggressive)
AFP and hCG: teratocarcinoma (mixed kind)

seminoma: alkaline phosphatase (50% of cases) and AFP (10%)

Answer: according to question i will go with "lymphoma" but yes for lymphoma age should be > 60. so
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Old 07-23-2012
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went thru goljan....its seminoma.....
i guess im studying too much these days
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Old 07-23-2012
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Lymphoma..

Seminoma is cystic to soft often confused with hydrocoele and definitely not hard.. Rest would show some positivity for markers
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Quote:
Originally Posted by Casandra View Post
A 42-year-old develops a painless mass in his left scrotal sac that was not present 3 months ago. Physical examination shows an enlarged testis which is firm. The right testis is normal. Laboratory studies show an absence of serum human chorionic gonadotropin (hCG) and α-fetoprotein (AFP). Histology of the tumor showed extensive lymphocytic infiltration. What kind of tumor is this most likely to be?

a) Choriocarcinoma
b) Lymphoma
c) Seminoma
d) Teratoma
e) Yolk sac tumor

They are not mentioned the positivity of alkaline phosphatase I will go with B
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Old 07-23-2012
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C)...
Seminoma...
waiting 4 u to reveal the answer..
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i think is seminoma
age 30-35;>65,gray tumor without homorrhage or necrosis.large cells with centrally located nucleus containing prominent nucleoli. lymphocytic infiltrate.metastasis:lymphatic (paraaortic lymph nodes )before hematogenous (lungs) increase in hCG in 10%,increase placental alkanine phosphatase
lymphoma-most common testicular cancer in men >60 years of age,secondary involvement of both testes by diffuse large cell lymphoma
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Old 07-28-2012
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Default correct answer :)

The answer is C) Seminoma

This is the commonest tumor of the testis. It is composed of large polyhedral cells with distinct cell membranes and clear cytoplasm, which are admixed with lymphocytes with or without granulomas. Classic seminomas do not secrete hCG or AFP.

For me also the buzzword was "lymphocytic infiltration" - I see that only in questions on seminoma.

As for lymphoma - it involves both the testicles and is rarely unilateral.
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