2 Objectives By the end of this session the student should be able to: List common causes of scrotal swellingClassify testicular tumorsList the gross and microscopic features of germ cell tumors
3 Scrotum Scrotal enlargement Squamous cell carcinoma and chimney sweeps Hydrocele: accumulation of serous fluid in the tunica vaginalisHematoceleChyloceleSquamous cell carcinoma and chimney sweeps
4 Cryptorchidism Undescended testis 0.7-0.8% of males Descent occurs in the last 2 months of intrauterine lifeRisk factors:Hormonal abnormalitiesPrematurityTesticular abnormalitiesMechanical problemsCongenital syndormes
5 Cryptorchidism Right > left Can result in infertility Risk of malignancy : x4May result in atrophyTubular atrophy, hyalinizationHyperplasia of leydig cellsIntratubular germ cell neoplasia
6 Epididymitis, Orchitis Infections (acute, chronic, granulomatous)Follow UTIAssociated with mumps in 20% of adults, rare in children
14 A 35-year-old healthy male with a past history of cryptorchidism repaired at age 5 presented with painless enlargement of the left testis. The mass was opaque on transillumination. A testicular ultrasound examination revealed the enlargement to be composed of soft tissue without a cystic component.Laboratory data included serum HCG of 90 mU/mL (ref. range < 5 mU/mL) and AFP of 7 ng/mL (ref. range 0-44 ng/mL).A radical left orchiectomy was performed.
15 The left testicle was dominated by a 4. 0-cm, pink-tan nodular mass The left testicle was dominated by a 4.0-cm, pink-tan nodular mass. An abdominal CT scan revealed para-aortic lymphadenopathy; a chest x-ray was normal. Radiotherapy was given to the abdominal retroperitoneal region.