Scrotal masses

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Scrotal masses
2010-11-18 03:37:29
Scrotal masses

Scrotal masses
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  1. What are the common causes of scrotal masses?
    • Within testes, transluscent (T): hydrocoele
    • Within testes, non-T: testicular ca, syphilitic
    • gumma
    • Separate from testes, T: epididymal cyst, spermatocoele
    • Separate from testes, non-T: chronic epididymitis

    Other: variecoele, undescended testes, inguinal hernia
  2. What is the pathophysiology underlying indirect inguinal hernia?
    • Failure of obliteration of patent processus vaginalis.
    • This allows bowel contents to herniate through deep inguinal ring through inguinal canal.
  3. Describe the pathogenesis of torsion of testes.
    • Normally, the tunica vaginalis attachments prevent torsion.
    • Congenital abnormality allow increased mobility of testes
    • Testicular non-descent
    • Absence of scrotal ligaments
    • Testicular atrophy
    • Pecipitating event e.g. trauma
  4. What are the causes of chronic and acute epididymo-orchitis?
    • Acute: Chlamydia & N. gonorrhoea for <40 yo, Pseudomonas & E.coli for >40 yo.
    • Chronic: TB, or progression from acute infection
  5. List the factors predisposing to testicular neoplasms.
    • Cryptorchidism (10% of testic tumours) – the higher the testis, the greater the cancer risk.
    • Genetic
    • Genomic changes
    • Testicular dysgenesis e.g. Klinefelter
  6. Compare seminomatous germ cell tumours and non-seminomatous germ cell tumours of the testes.
    • Seminomatous germ cell tumours: peak 30yo, 70% are stage I, localised and better prognosis
    • Non-seminomatous germ cell tumours: common in young but occur in all ages, stage II &III, haematogenous spread to lungs/liver/brain
  7. How are AFP, hCG and LDH related to testicular tumours?
    • AFP: +ve in yolk sac tumours (non-S)
    • hCG: +ve in choriocarcinomas (non-S)
    • LDH: for tumour load