Male Genital System Testis & epididymidis Ductus deferrens Prostata & vesiculae seminales Penis

Testis Necrosis Atrophy Inflammation Tumours

Atrophia testium Cryptorchidism Klinefelter´s sy estrogen administration hypopituitarism aging malnutrition cachexia radiation chemotherapy alcoholic cirrhosis

Granulomatous orchitis infectious syphlis tuberculosis leprosy fungi brucellosis parasites rickettsiae…. idiopathic trauma ischemia postobstructive changes G- urinary tract infection... mimicking a neoplasm PSEUDOTUMOUR

Germ cell tumours seminoma embryonal carcinoma teratoma (mature, immature) yolc sac tumour choriocarcinoma RISK FACTOR: CRYPTORCHIDISM 5x increased

Seminoma (50%) „classic“ spermatocytic frequent as both pure & combined peak incidence 40 years swelling monomorphous germinal cell population may present with metastases c-kit + (membranously) spermatocytic rare (1% of all seminomas) peak incidence 50 years swelling polymorphous cell population does not metastasize! dif. dg. anaplastic seminoma

Embryonal carcinoma composed of primitive anaplastic-appearing epithelial cells pure rare, mostly in combined germ cell tumours peak incidence 30 years swelling, 2/3 patients with metastases at diagnosis macro : tan/gray, necroses, hemorrhages micro: solid, tubular, PLAP, CK +

Mesoblastoma vitellinum- yolc sac tumour –endodermal sinus tumour 80% of prepubertal germ cell tumours in postpubertal as admixture painless mass, serum AFP elevated macro: gray/tan nonencapsulated micro: many variants – microcystic, solid,festoon-like, hepatoid, spindle cell… AFP+, alpha1-Antitrypsin

Choriocarcinoma pure – 0,5% of testicular tumours admixture in many germ cell tumours highly malignant postpubertal , 2nd-3rd decade presents often with metastases beta-HCG

Teratomas Def.: Tumours (benign or malignant) composed of two or more different cell lines that are NOT normally present in the place of tumour origin

Teratoma coetaneous – differentiated -cystic embryonal – nondifferentiated - solid

Prostate Necrosis , atrophy Inflammation HYPERPLASIA CARCINOMA

(Benign) Prostatic Hyperplasia starting over 40, 90% men over 70 years of age dyshormonal, often symptomless dysuria - retention: infection, infarction, stones hydropyelonephritis, urosepsis

Carcinoma prostatae frequent by chance finding at autopsy most men die with, not from the prostate cancer etiology unknown Serum PSA, sonography discovering clinically silent forms hormonal dependency precanceroses PIN (LG, HG)

Diagnosis of the Prostate Cancer PSA, thick needle biopsy histology immunohistochemistry 34β E12, PSA grading : Gleason grade (1-5) & score (2-10) staging

Penis congenital anomalies acquired hypospadia, epispadia (changed positions of the urethra openings) phimosis paraphimosis acquired infections neoplasms