#schiller duval body

[mcatmemoranda]

Choriocarcinoma typically affects younger men in the age range of 15 to 35-years-old. These tumors are associated with the development of gynecomastia due to the secretion of beta human chorionic gonadotropin, which has similar properties to luteinizing hormone. Patients can present with precocious puberty, gynecomastia, impotence, or loss of libido. Histologically, a choriocarcinoma will show the presence of both syncytiotrophoblastic cells and cytotrophoblastic cells.

Sertoli cell tumors are derived from the cells located within the seminiferous tubules, and can occur in both children and in middle-aged adults. Histology will reveal uniform tall polyhedral cells that are arranged in sheets and cords that resemble spermatic tubules. The presence of perinuclear aggregates of intermediate filaments is pathognomonic of a Sertoli cell tumor. Inhibin-alpha is a tumor marker.

Yolk sac tumor is the most common testicular neoplasm in infants, with an average age of diagnosis between 1 to 2-years-old. Children with yolk sac tumors usually present with a painless testicular mass. Histologically, the presence of Schiller-Duval bodies is pathognomonic of yolk sac tumors. Schiller-Duval bodies contain a central vessel that is surrounded by flattened tumor cells in a cystic space. The tumor marker for yolk sac tumor is alpha-fetoprotein.

A histological examination of Leydig cell tumors will reveal the presence of Reinke’s crystals in the interstitial cells of the testis. Reinke’s crystals are rod-shaped intracytoplasmic crystal-like inclusions with rounded ends.

[neet-ss-test-series]

Reproductive medicine and Surgery and Gynae oncology Neet SS

A very special branch and nowadays much sought out branch. Many new Mch aspirants want to have super specialization in Reproductive medicine and Surgery and Gynae oncology.

NEET SS test series is a super specialization exam. It is conducted as an online exam now.

The pattern of exams has also changed and Mch aspirants need to be specific as what to study.

Mch is related to surgical Specialities. Mch Reproductive medicine and Surgery and Gynae oncology are new upcoming and very exciting branches and some Hospitals and Medical Colleges are coming up with Super specialization in these fields although the number of seats is not that big. These branches are gaining Scope.

NBE Changed the pattern to online exams as CBT exam. The Mch exams as a whole are now conducted as online MCQ Based exam.

Details of Mch Reproductive medicine and Surgery and Gynae oncology

Examination

Exam: Neet ss Reproductive medicine and Surgery and Gynae oncology.

§ Conducted by : NBE

§ Eligibility: MS Surgery

§ Level: Pg Superspeciality

§ Duration: 3 years

§ Probable Upcoming Dates: September/October or Beyond

§ Question Type : MCQs

§ Exam : Single Day Online Examination

Mch aspirants are always in search of what to study and what is asked in Mch exams. Our Experts found that a great depth of basic facts and profound knowledge of Anatomy, surgical anatomy, embryology is needed as students are tested on the basics as well.

So what to Study for Neet ss Reproductive medicine and Surgery and Gynae oncology.

A Mch Aspirant should be well versed with Surgical Anatomy and especially embryology. Some topics asked in last few examinations are about :

§ Primordial Germ cell

§ Coelomic epithelium

§ Genital ridge mesenchyme

§ Mesonephric tubules

§ Mesonephric duct (wolfian duct)

§ Paramesonephric duct(Mullerian duct)

§ Genital tubercle

§ Urogenital folds

§ Labioscrotal swellings

§ Urogenital sinus

A Mch Aspirant should be well versed with Defects which are examiners favorite. Top on mind of examiners are:

· Bicornuate uterus

· Arcuate uterus

· Uterus didelphys

· Complete septum

· Unicornuate uterus

· Mullerian agenesis

For Mch Gynae Oncology it is important to know about topics especially listed below. These topics should be studied in full detail from all available standard text books.

§ Arrhenoblastoma

§ Call –Exner bodies

§ Endometrial stromal sarcoma

§ Carcinosarcoma

§ Leiomyosarcomas

§ Granulosa cell tumour

§ Sertoli-Leydig cell tumour

§ Hilar cell tumour

§ Renkies Crystals

§ Thecoma

§ Krukenbergs tumour

§ Lipoid cell tumour

§ Signet Ring cells

§ Endodermal Sinus tumour

§ Schiller Duval bodies

§ Psammoma Bodies

§ Serous tumours

§ Fibroma

§ Meigs Syndrome

§ Brenner tumour

§ Pseudomeigs Syndrome

§ Estrogen- producing

§ Granulosa cell tumour

§ Carcinoid(Seratonin- producing)

§ Thyroid tumour(Struma Ovarii)

§ Choriocarcinoma of the ovary

For Mch Neet ss Reproductive medicine and Surgery and Gynae Oncology it is important to know about topics especially listed below. Our experts and NEET SS Students should be able to differentiate between different types of masses.

§ Follicle Cysts

§ Corpus luteum cysts

§ Theca lutein cysts

§ Inflammatory(T.O.abscess)

§ Endometritic Cysts

§ Benign teratoma(dermoid cysts)

§ Malignant teratoma

Use of Drugs is very important. Various questions in Reproductive medicine and Surgery on Drugs, their doses, use and side effects have been asked in recent Neet ss exams. Notably students should have knowledge about drugs like

§ Progestogens

§ Androgens

§ Danazol

§ GnRH analogues

§ Clomiphene

§ Metformin

§ OCPS

§ Barrier devices

§ Male contraceptives

Use of Drugs is very important. Various questions in Gynaeoncology on Drugs, their doses, use and side effects have been asked in recent Neet ss exams. Notably students should have knowledge about drugs like

§ Abagovomab

§ Aminoglutethirnide

§ Busurelin

§ Cetorelix

§ Cisplatin

§ Diethyistilbesterol

§ Ertumaxomab

§ Ethinyl estradiol

§ Flutamide

§ Formestane

§ Ganirelix

§ Goserelin

§ Letrozole

§ Leuprolide

§ Medroxyprogesterone acetate

§ Methotrexate

§ Nafarelin

§ Tamoxifen

§ Doloxifen

§ Trastuzumab

§ Vorozole

What is important and frequently asked in reproductive medicine is about topics below. They need to be studied in detail .

§ Adenoma(Prolactinoma)

§ Sheehans syndrome

§ Simmonds disease

§ Premature Thelarche

§ Premature Puberche

§ Premature Menarche

Important Surgeries which are frequently in examiners mind.

§ Boari Flap Technique

§ BSO

§ Chassar Moir Technique

§ Conisation

§ Cryotherapy

§ Hysterectomy

§ IVF Techniques

§ Laser Ablation or vaporization

§ LEEP

§ Mc Donald/Shirodkar Cerciage

§ Omentectomy

§ Straussman Unification Surgery

§ TAH

In Reproductive medicine Even Expect Questions on Basic Topics like

§ Barrier method

§ Natural contraception

§ Oral contraceptive pill

§ Injectables

§ Implants

§ Nova T/Multiload 375/Levonova

§ CuT 380 A

§ Progestasert

§ CuT 200B

§ Levonorgestrel containing IUCD

We would stress the need to focus on basics. It is important to know physiology and biochemistry about important hormones such as below. Lots of questions are asked on these topics.

§ Human chorionic Gonadotrophin(HCG)

§ Human Placental Lactogen(HPL)

§ Human Chorionic Thyrotrophin(HCT)

§ Human Chorionic Corticotrophin(HCC)

§ Pregnancy specific Beta-1 Glycoprotein

§ Estriol

§ Estradiol

§ Estrone

§ Progesterone

A detailed knowledge in Oncology is tested about cancers of genitalia especially.

This forms a large chunk of questions and no one can afford to miss them. Questions on subtypes are also asked minutely.

§ Cervix Cancer

§ Fallopian tubes Cancer

§ Breast Cancer

§ Ovarian Cancers

§ Endometrial Cancers

§ Premalignant Lesions

§ Carcinoma in Situ

§ HPV Strains

§ Lynch type II syndrome

§ Non polyposis coli

§ Familial inheritance of cancer ovary

§ Familial breast, ovarian cancer

§ Premalignant lesion of cancer cervix

§ Dysplasia

§ CIN I LSIL

§ CIN II HSIL

§ CIN III HSIL

§ Ca in situ HSIL

§ Invasive cancer

These Topics are asked in detail.

Mch Aspirants for Neet ss mock test Reproductive medicine and Surgery and Gynae oncology should start well in time and be regular in studies in addition to practicing as any Mcqs as possible. Online tests are of greatest value .Standard text books for all important topics are a must.

[hospitalmakkar-blog]

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[mcatmemoranda]

Yolk sac tumors have poor prognosis in adults, who usually have embryonal carcinoma mixed with it. All three germ cell layers = ecto-, meso-, and endoderm. In post-pubertal males, all teratomas are considered malignant with capacity for metastasis.

[mcatmemoranda]

Schiller-Duval bodies are seen in yolk sac tumors. They are glomerulus-like structures. They are central blood vessels surrounded by germ cells within a space lined by germ cells.

From Wikipedia:

Schiller–Duval body is a cellular structure seen by microscope in endodermal sinus tumors (yolk sac tumors) which are the most common testicular cancer in children. Schiller-Duval bodies are present in approximately 50% of these tumors, and if found are pathognomonic.[1] They are named for Mathias-Marie Duval and Walter Schiller[2] who described them in the late nineteenth century.[3]

Schiller–Duval bodies are said to resemble a glomerulus.[4] They have a mesodermal core with a central capillary, all lined by flattened layers of both visceral and parietal cells. Immunofluorescent stain may show eosinophilic hyalin-like globules both inside and outside the cytoplasm that contain AFP and alpha 1-antitrypsin.

[mcatmemoranda]

I drew it out so it's easier to see.

Endodermal sinus tumors are also called "yolk sac tumors" and they make AFP and have Schiller-Duval bodies.

Fibromas are also called "fibroma-thecomas." They can cause Meigs syndrome (fibroma + ascited + hydrothorax).

Ovarian Cancer Staging:

I – growth to one/both ovaries

II – with extension to pelvic structures

III – peritoneum

IV – distant mets

Treatment: adjuvant chemo (cisplatin and taxol)

XRT (radiotherapy) in stage II/III

Follow CA125 because increased in 80%

[mcatmemoranda]

Wow. I should've gotten this question right! I chose "yolk sac tumor," but the yolk sac doesn't make beta hCG, the placenta does. The chorion contributes to the formation of the placenta, so it secretes beta hCG and the pt had choriocarcinoma.

Choriocarcinoma typically affects younger men in the age range of 15 to 35-years-old. These tumors are highly malignant and can be associated with gynecomastia or testicular enlargement. This is because this tumor secretes beta human chorionic gonadotropin, which has an analogue similar to luteinizing hormone. Thus, patients can present with precocious puberty, gynecomastia, impotence, or loss of libido. On physical examination, testicular tumors are firm, nontender masses that do not transilluminate. Histological evaluation of a choriocarcinoma shows the presence of both syncytiotrophoblastic cells and cytotrophoblastic cells.

Yolk sac tumor, also known as endodermal sinus tumor, is the most common testicular neoplasm in infants and children. Yolk sac tumors have a median age of onset of 1 to 2-years-old. Children with yolk sac tumors usually present with a painless and bulky testicular mass. Histologically, a honeycomb pattern is seen in which a reticular network is formed by the vacuolated cytoplasm of tumor cells. The presence of Schiller-Duvall bodies is pathognomonic of yolk sac tumors. Schiller-Duvall bodies take the appearance of a central vessel that is rimmed by fibrous tissue and surrounded by malignant epithelial cells in a cystic space. The tumor marker for yolk sac tumor is alpha-fetoprotein.

Bottom Line: The tumor marker for choriocarcinoma is beta human chorionic gonadotropin. The tumor marker for yolk sac tumors is alpha fetoprotein. Testicular sex cord stromal tumors such as leydig cell tumors and sertoli cell tumors have inhibin-alpha as its tumor marker.