Pathology of Tumours of the Male Genital Tract

Tumours of the male genital tract are common and are increasing in frequency, particularly in the ‘Western’ world. The most common tumours are those of the testis and prostate, although penile and urethral tumours are occasionally encountered. Testicular and prostatic tumours occur in different age groups. Testicular tumours are the most common malignant solid tumour in young men in their third and fourth decade. Prostate cancer is the most common tumour in older men and, in England and Wales, is the second most common malignant cause of death after lung cancer. There have been significant advances in the diagnosis of both of these tumour types, and in understanding their pathology, particularly of the preneoplastic phase.

The high incidence of prostatic carcinoma and its increasing morbidity and mortality have led to calls for the development of a prostate cancer screening programme. A combination of digital rectal examination and serum prostate-specific antigen (PSA) analysis is effective in diagnosis with subsequent transrectal ultrasound-guided needle biopsy. However, there is significant sampling error entailed in these procedures with a risk of false-negative screening data. It is also remains debatable whether a small, early lesion detected by a screening programme would show any benefit from therapeutic intervention at this stage. Pilot studies of prostate carcinoma screening are under way in a variety of countries, but there are no data of the efficacy of these programmes.