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2.1
Testicular Choriocarcinoma
Testis Choriocarcinoma

Presentation

His presentation suggested chronic, rather than acute, gastrointestinal blood loss. [ncbi.nlm.nih.gov]

Entire Body System

  • Asymptomatic

    Testicular choriocarcinoma is an exceptional cause of choroidal metastasis, potentially asymptomatic and with specific clinical features. [ncbi.nlm.nih.gov]

    The coincidentally discovered asymptomatic tumour in the right eye was treated before vision was affected. [bmcurol.biomedcentral.com]

    […] affecting the fovea.3 Contrary to the majority of uveal metastases, choriocarcinoma metastases to the choroid are unlikely to be asymptomatic. [retinalphysician.com]

    On physical examination, he had hard slightly enlarged asymptomatic left testes, left cervical lymphadeonopathy, hepato-splenomagaly, several palpable masses within the abdomen and scrotal swelling. [jpma.org.pk]

  • Inflammation

    Comprehensive in scope, this title begins with a look at normal anatomy and histology for each organ system...followed by discussions of the pathology of congenital anomalies, inflammations, non-neoplastic diseases and neoplasia. [books.google.de]

    In his recent pathological history the patient reported testicular inflammation 1 year earlier. Physical examination revealed a minimum increase of breast tissue bilaterally and centimetric mass in the right testis. [karger.com]

Respiratoric

  • Cough

    In this study we present a case of testicular choriocarcinoma, who presented with abdominal pain, cough, generalized weakness and left sided cervical mass. Incisional biopsy of cervical mass was performed. [ncbi.nlm.nih.gov]

    Hemoptysis (coughing up blood) and back pain. Pure tumors are extremely uncommon with most tumors part of a mixed germ cell neoplasm. These tumors characteristically secrete hCG into the serum. [humpath.com]

    In metastatic disease (10% of cases) Cough, shortness of breath, chest pain Lower back or bone pain Gynecomastia Paraneoplastic hyperthyroidism Until proven otherwise, a firm nodule on the testis should be considered cancer! [amboss.com]

  • Dyspnea

    抄録 A 54-year-old man was referred to our hospital because of progressive dyspnea. Chest computed tomography showed multiple nodular shadows with a peripheral ground-glass halo. [jstage.jst.go.jp]

    Clinical case We present a clinical case where a 25-year-old male with no significant medical background was admitted showing asthenia, adinamy, general discomfort, hiporexy, dizziness, palpitations, dyspnea, melenic stool and a six kilo weight loss within [scielo.isciii.es]

    Microscopic pulmonary tumor emboli associated with dyspnea. Cancer 1975 ; 36 : 1473 – 82. 27. Gleason, PE, Elliott, DS, Zimmerman, D, Smithson, WA, Kramer, SA. [cambridge.org]

    […] the gonads, anywhere along the body's midline from the pineal gland to the coccyx Epidemiology : 5–10% of all germ cell tumors ; mostly affects young males Location : midline organs ; mediastinal > retroperitoneal > intracranial Symptoms : Chest pain, dyspnea [amboss.com]

    Most patients were hypoxemic, and all of them had dyspnea at the time of the admission to the ICU. [frontiersin.org]

Gastrointestinal

  • Vomiting

    Blood pressure in the cancer approaches are directed towards the eradication or modifi patient, therapy for nausea and vomiting as well as pain are cation of the properties of heterogeneous malignant tumor discussed. [books.google.de]

    Complications 1401 Cardiac Complications 1411 Neurologic Complications of Therapy 1418 Acute Toxicities of Therapy Urologic Complications 1426 Issues in Vascular Access with Special Emphasis on the Cancer Patient 1434 Management of Cancer Pain 1446 Nausea and Vomiting [books.google.ro]

    The patient called and was examined two days later due to intractable nausea and vomiting. His vision at this visit was barely light perception. The IOP in the right eye was 37 mm Hg by applanation. [retinalphysician.com]

    Indications for Choriocarcinoma of the Testis include: Blood in vomit and cough Blood in stool, urine Trouble breathing Headache Low blood pressure Anemia Testicular pain, lump in the testes, feeling of heaviness in the scrotum Abdominal pain and swelling [dovemed.com]

  • Nausea

    Blood pressure in the cancer approaches are directed towards the eradication or modifi patient, therapy for nausea and vomiting as well as pain are cation of the properties of heterogeneous malignant tumor discussed. [books.google.de]

    Complications 1401 Cardiac Complications 1411 Neurologic Complications of Therapy 1418 Acute Toxicities of Therapy Urologic Complications 1426 Issues in Vascular Access with Special Emphasis on the Cancer Patient 1434 Management of Cancer Pain 1446 Nausea [books.google.ro]

    The patient called and was examined two days later due to intractable nausea and vomiting. His vision at this visit was barely light perception. The IOP in the right eye was 37 mm Hg by applanation. [retinalphysician.com]

    Advanced symptoms include: neck mass; coughing or trouble breathing; stomach problems such as nausea, vomiting, bleeding or anorexia; lower back pain; bone pain; nerve pain or leg swelling. [testicularcancersociety.org]

Musculoskeletal

  • Bone Pain

    As choriocarcinoma in males has a very high propensity to spread haematogenously, it usually presents with systemic symptoms, like haemoptysis in case of respiratory involvement, abdominal pain and haematemesis in GI involvement and bone pains in case [jpma.org.pk]

    In metastatic disease (10% of cases) Cough, shortness of breath, chest pain Lower back or bone pain Gynecomastia Paraneoplastic hyperthyroidism Until proven otherwise, a firm nodule on the testis should be considered cancer! [amboss.com]

    Advanced symptoms include: neck mass; coughing or trouble breathing; stomach problems such as nausea, vomiting, bleeding or anorexia; lower back pain; bone pain; nerve pain or leg swelling. [testicularcancersociety.org]

Neurologic

  • Hyperactivity

    This rare mutation is predicted to constitutively activate Ras-GTP and lead to hyperactive Ras signaling [ 19 ]. We also detected mutations in XRCC2 in 3/5 patients with refractory disease. [journals.plos.org]

Urogenital

  • Testicular Mass

    The histopathological assessment of the biopsied tissue, in combination with elevated serum β-HCG levels and presentation of testicular mass, indicated primary testicular choriocarcinoma with cutaneous and systemic metastasis. [ncbi.nlm.nih.gov]

    In order to be able to treat these patients appropriately, a provider must recognize characteristic features of choriocarcinoma including elevated human chorionic gonadotropin in a young man with testicular mass; the astute clinician should also know [mayoclinic.pure.elsevier.com]

    Testicular ultrasound confirmed a left testicular mass. [acgcasereports.gi.org]

    Although chemotherapy may result in disappearance of the testicular mass, orchiectomy is always indicated for accurate diagnosis. [article.sapub.org]

Workup

Therefore, serum markers for germ cell tumors should be sent as part of the initial workup for men in this age range presenting with metastatic disease. [surgicalneurologyint.com]

Postdiagnostic workup of an NSGCT includes chest/abdominal/pelvic computed tomography, repeat bHCG, LDH, and AFP levels, and brain MRI if indicated. [urologyannals.com]

Review Topic QID: 106375 5 No further workup, instruct patient to return if symptomatic M1 Select Answer to see Preferred Response PREFERRED RESPONSE 2 Sorry, this question is for PEAK Premium Subscribers only ARTICLES (4) VIDEOS (1) Topic COMMENTS (12 [medbullets.com]

He was sent to his primary care physician for a physical exam and a coagulability workup. The physical exam failed to provide any additional information, and the coagulability workup was negative. [retinalphysician.com]

After detailed history and physical examination, his metastatic workup was done. [jpma.org.pk]

Treatment

Treatment options include orchiectomy +/- combination chemotherapy. choriocarcinoma testicular germ cell tumors Promoted articles (advertising) [radiopaedia.org]

Choriocarcinoma is a unique and aggressive germ cell malignancy, and these patients require early aggressive treatment to improve their chance of survival. [mayoclinic.pure.elsevier.com]

Treatment Outcome Treatment Approaches Without a Reduced-Dose Intensity During Induction Chemotherapy There is no effective preventive precaution against the choriocarcinoma syndrome. [frontiersin.org]

Oncology is a very rapidly changing speciality, with many new treatments and even treatment modalities coming on stream with bewildering speed. [books.google.ro]

Additional treatment following orchiectomy can reduce the risk of disease recurrence, but will overtreat many patients. [med.unc.edu]

Prognosis

Choriocarcinoma produces high levels of β-hCG, with levels > 50,000 mIU/ml conferring a particularly poor prognosis [ 9 ]. [ncbi.nlm.nih.gov]

Etiology

Etiology and epidemiology Choriocarcinoma of the placenta during pregnancy is preceded by: hydatidiform mole (50% of cases) spontaneous abortion (20% of cases) ectopic pregnancy (2% of cases) normal term pregnancy (20-30% of cases) hyperemesis gravidarum [ipfs.io]

(Etiology) The cause of Choriocarcinoma of the Testis is unknown. [dovemed.com]

In patients with wide-spread tumoral disease and gastrointestinal hemorrhage, endoscopic management should be individualized according to personal and clinical characteristics, in order to obtain etiological information on the hemorrhage, a histological [scielo.isciii.es]

Testicular tumors: epidemiologic, etiologic and pathologic features. Cancer 1973 ; 32 : 1186 – 201. 4. Zondek, B. Versuch einer biologischen (hormonalen) diagnostik beim malignen hodentumor. Chirug 1930 ; 2 : 1072 – 80. 5. [cambridge.org]

Etiology Risk factors Cryptorchidism (increased risk for germ cell tumors ) [4] Contralateral testicular cancer Germ cell neoplasia in situ (GCNIS) Family history of testicular cancer Klinefelter syndrome, Down syndrome (increased risk for germ cell tumors [amboss.com]

Epidemiology

[…] background. large multinucleated cells with smudged nuclear chromatin (syncytiotrophoblast) syncytiotrophoblasts form a "cap" around clusters of cytotrophoblasts hemorrhagic and necrotic foci residual scar as the only evidence of prior existence of the tumor Epidemiology [humpath.com]

[…] more common in Hispanics compared to Asian and black populations in the US References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified. [amboss.com]

[…] trophoblast cells Identical tumors arise in placenta, ovary, mediastinum and abdomen (from sequestered cell rests) Essential features Hemorrhagic mass Early metastases Three cell types: syncytiotrophoblast, cytotrophoblast, intermediate trophoblast Epidemiology [pathologyoutlines.com]

National Cancer Institute – Surveillance, Epidemiology and End Results Program. Available from: https://www.seer.cancer.gov/statfacts/html/testis.html. [Last retrieved on 2017 Nov 28]. 5. Reilley MJ, Pagliaro LC. [urologyannals.com]

Introduction Testicular tumors can be of germ cell or non-germ cell origin germ cell origin are the majority (95%) and are more commonly malignant non-germ cell origin usually benign Epidemiology incidence most common cancer in men between 15-35 years [medbullets.com]

Pathophysiology

It brings together the pathophysiology of disease with detailed clinical guidance on diagnosis and management for the full range of childhood cancers, including aspects important in optimal supportive care. [books.google.de]

Epidemiology : usually develop after the age of 4 Pathophysiology : produces ↑↑ amounts of testosterone and a small amount of estrogen, progesterone, and corticosteroids → testosterone excess causes precocious puberty in males (and masculinization in [amboss.com]

Pathophysiology The exact pathogenesis of choriocarcinoma syndrome is currently unknown. [frontiersin.org]

Pathophysiology and Etiology Choriocarcinoma recapitulates placental tissue development. [emedicine.medscape.com]

Gynecomastia: pathophysiology, evaluation, and management. Mayo Clin Proc. 2009 ;84: 1010 – 1015. [Google Scholar] 2. Schmoll HJ. Extragonadal germ cell tumors. Ann Oncol. 2002 ;13 Suppl 4: 265 – 272. [Google Scholar] 3. [journals.aace.com]

Prevention

Prevention It’s not possible to prevent testicular cancer since most of the risk factors (young age, undescended testicles, being white, etc.) cannot be changed or controlled. [urmc.rochester.edu]

Treatment Outcome Treatment Approaches Without a Reduced-Dose Intensity During Induction Chemotherapy There is no effective preventive precaution against the choriocarcinoma syndrome. [frontiersin.org]

Prevention There is no known means of prevention. However, early detection of the symptoms and prompt medical treatment can improve the odds of survival. KEY TERMS Biopsy — A sample of an organ taken to look for abnormalities. [encyclopedia.com]

Prevention The primary prevention of choriocarcinoma is the early detection of hydatidiform mole to employ early removal and management of the condition. [cancerwall.com]

Transplantation Substance Use and Addiction Surgery Surgical Innovation Surgical Pearls Teachable Moment Technology and Finance The Rational Clinical Examination Tobacco and e-Cigarettes Toxicology Trauma and Injury Treatment Adherence United States Preventive [jamanetwork.com]

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