Tumors of the testis and epididymis

Primary tumors of the epididymis are extremely rare and, as a rule, are benign fibroids, lipoma and others).
Tumors of the testis be about 9% of all tumors of the urinary system in men.
Benign tumors of the testis - fibroma, handsome, osteomas, dermody are casuistic rare. In most cases, the tumors of testicular malignancy. There are three basic groups:
1) tumors of epithelial origin - seminomy and adenocarcinoma;
2) heterotypic tumor - teratoid tumors, teratodinae tumors, horionepitelioma;
3) tumor tissue of nature - sarcoma.
Tumors of the testis are found mainly aged between 20 and 40 years. Right and left testicle are affected equally often.
Cryptorchidism predisposes to the development of tumors of the testis. Pathogenetic role of injury and inflammation of the testis unclear.
Among malignant tumors of the testis first frequency place seminomy - specific testicular tumors, the second - teratodinae tumor; the other forms are less common.
Seminoma typical structure is a tumor is grayish-white in color, soft consistency with the centers of the seal. It comes from the germinal epithelium of the seminiferous tubules and consists of homogeneous large cells of the round form with poorly painted by the kernel. The tumor is rich in stroma. Atypical seminoma different cell polymorphism frequent mitoses and vast areas of necrosis. The stroma is poorly developed. Although all seminomas malignant, typical forms are more favourable than atypical. Last metastasize and cause cachexia much faster.
Adenocarcinoma of the testicle, as atypical seminomy are very different malignant.
From heterotypic tumors are most often found teratoid tumors and teratodinae tumors. In those building and other involved all three embryonic leaf. In teratoma often rudimentary organs or parts of them, gland, bone, cartilage. Teratoid tumors occur mainly in children. They potentially malignant, almost proceed relatively well not cause cachexia, not give metastases and not recur after removal of the testicle. Less Mature form - turacoena tumor - built similarly, but does not contain rudimentary organs. In contrast to teratoma this form peculiar to highly malignant course.
The malignant tumors of the testis is chorionepithelioma, growing from the chorionic villi. It consists of Securityowner syncytial and transparent giant cells. In tumor tissue are found extensive bleeding. Horionepitelioma are characterized by rapid destructive growth and early metastasis.
Tumors of the testis arise in the thickness of its parenchyma, the appendage involved again or remains unaffected. They first do not cause pain. The pain usually occurs when a sudden acceleration in growth of the tumor involvement of the spermatic cord. Pain felt in the testis and along the spermatic cord.
Metastasis of testis tumors occurs through the lymph system. Therefore the first to be affected regional lymph nodes along the spermatic vessels, inferior Vena cava and abdominal aorta. The tumor is metastases in the lungs, mediastinum, liver, spine, brain.
During unfavorable. Patients die from metastases and cachexia. The prognosis is better if the disease is detected early and testicle is removed before the occurrence of metastases.
The diagnosis. In the survey are increased, sealed, smooth or bumpy egg, mostly painless. Seed cord depending on the stage of the disease is thickened or not modified, but the ductus deferens is always intact. Necessary on the abdomen to determine the retroperitoneal metastases in lymph nodes. Often these metastases can be recognized by panoretrograph, as large packages affected retroperitoneal glands reject the upper part of the ureter in the lateral side (kidney tumors reject his medial).
Malignant tumors of the testis - seminomy and especially teratodinae tumor is often accompanied by increased content in the urine of prolana (hormone of the anterior pituitary gland). The positive reaction of Asheim - Condeca in urine allows in case of doubt to diagnose testicular tumor, negative same - not exclude it. A positive reaction, does not disappear or appear after removal of the testicle, indicates the presence of metastases.
Unlike tuberculosis tumor affects first the egg from which the process moves to the epididymis.
For hydrops of the testicle envelopes characterized by long and benign course, translucent in transmitted light.
The treatment is the removal of the testicle. Seed cord cross highly outside of the inguinal rings. You can delete and retroperitoneal lymph nodes. Despite the radical nature of this traumatic operations, it does not guarantee from leaving small tumor metastasis.
Metastatic tumors (except metastases teratogenic tumors) are very sensitive to x-rays. So long exposure paranormalnyh glands after surgical intervention is required.