外科学教学课件：泌尿系癌和阻滞.ppt

Testicular Carcinoma the most common malignancy in men in the 15- to 35-year age group Germ Cell Tumors Seminoma Classic (typical) Atypical Spermatocytic Nonseminomatous Embryonal carcinoma Teratoma Mature Immature Mature or immature with malignant transformation Choriocarcinoma Yolk sac tumor (endodermal sinus tumor) Non-Germ cell Tumors Classification of Testicular Carcinoma Incidence of Elevated Tumor Markers by Histologic Type in Testis Cancer hCG (%) AFP (%) Seminoma 7 0 Teratoma 25 38 Teratocarcinoma 57 64 Embryonal 60 70 Choriocarcinoma 100 0 Clinical Staging Stage I: lesion confined to the testis. Stage II: retroperitoneal nodal involvement (IIA 2 cm, IIB 2 cm). Stage III: supradiaphragmatic nodal involvement or visceral involvement. Treatment Radical inguinal orchiectomy Retroperitoneal lymph node dissection Chemotherapy radiotherapy Carcinoma of the penis Risk factor: poor hygiene T—Primary tumor TX: Cannot be assessed T0: No evidence of primary tumor Tis: Carcinoma in situ Ta: Noninvasive verrucous carcinoma T1: Invades subepithelial connective tissue T2: Invades corpus spongiosum or cavernosum T3: Invades urethra or prostate T4: Invades other adjacent structures N—Regional lymph nodes NX: Cannot be assessed N0: No regional lymph node metastasis N1: Metastasis in single superficial inguinal node N2: Metastasis in multiple or bilateral superficial inguinal nodes N3: Metastasis in deep inguinal or pelvic nodes M—Distant metastasis MX: Cannot be assessed M0: No distant metastasis M1: Distant metastasis present TNM Classification of Tumors of the Penis. Urinary obstruction Stasis Etiology Conge