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Testicular
Tumors
Testicular Tumors
• Testicular cancer represents 1% of all
cancers in men.
Testicular Tumors
Classification:
1. Germ cell tumors (GCTs): (95%) of primary testicular tumors.
a. Seminomas (45%).
b. N...
Testicular Tumors
Age:
• First Decade → Yolk Sac Tumors – Teratomas.
• Second & Third Decade → Teratoma & Choriocarcinoma....
Testicular Tumors
Tumors Markers:
• Alpha Fetoprotein → All Yolk Sac Tumors – 75% Of Embryonal
Carcinoma.
• Human Chorioni...
Testicular Tumors
Spread:
• Lymphatic Spread.
• Hematogenous Spread.
• Local.
Testicular Tumors
Clinical:
• Asymptomatic.
• Mass.
• Metastasis.
• Hormonal disturbance.
Imaging
Testicular Tumors
Plain X-Ray:
• Metastasis.
Testicular Tumors
CT:
• Staging
Testicular Tumors
MRI:
• Homogeneously hypointense on T2-weighted
images. Larger tumors may be more heterogeneous.
Testicular Tumors
US:
• Hypoechoic relative to
the surrounding
parenchyma.
Testicular Tumors
US:
• Seminomas are well defined within the tunica
albuginea and homogeneously hypoechoic
Testicular Tumors
US:
• Nonseminomatous lesions are more often cystic with
interspersed areas of calcification.
Testicular Tumors
US:
• Embryonal cell cancers are heterogeneous.
• The borders of the tumor are less distinct.
• More agg...
Testicular Tumors
US:
• Embryonal cell cancers.
Testicular Tumors
US:
Yolk Sac Tumor:
• Imaging findings are
nonspecific,especially in children,
in whom the only finding ...
Testicular Tumors
US:
Teratoma:
• Well-circumscribed complex
masses.
• Cysts are a common feature and
may be anechoic or c...
Testicular Tumors
US:
• Choriocarcinomas are often
heterogeneous with multiple
internal calcifications present.
Testicular Tumors
US:
• Leydig and Sertoli cell, are
generally well defined and
hypoechoic.
• Calcifications are frequentl...
Testicular Tumors
US:
• Testicular lymphoma generally
appears as discrete hypoechoic
lesions, which may completely
infiltr...
Testicular Tumors
“Burned-out" Germ Cell Tumor
• The patient may present with
widespread metastases even
though the primar...
Testicular Tumors
“Burned-out" Germ Cell Tumor
• The pathogenesis of this
phenomenon may be that the
high metabolic rate o...
Testicular Tumors
“Burned-out" Germ Cell Tumor
• These tumors are clinically
occult, with the testis being
normal to small...
Testicular Tumors
“Burned-out" Germ Cell Tumor
• US plays a vital role in the search
for the primary regressed tumor.
• Th...
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Testicular tumors

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Testicular tumors

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Testicular tumors

  1. 1. Testicular Tumors
  2. 2. Testicular Tumors • Testicular cancer represents 1% of all cancers in men.
  3. 3. Testicular Tumors Classification: 1. Germ cell tumors (GCTs): (95%) of primary testicular tumors. a. Seminomas (45%). b. Non-seminomas (50%): mixed GCTs (40%), Teratomas and teratocarcinomas (30%) Embryonal cell carcinoma (20%). Choriocarcinoma (1%). Yolk sac tumors 2. Gonadal Stromal Tumors: Leydig cell tumors and Sertoli cell tumor. 3. Secondary Tumors: Lymphoma, leukemia, and melanoma are the most common malignancies that metastasize to the testicle.
  4. 4. Testicular Tumors Age: • First Decade → Yolk Sac Tumors – Teratomas. • Second & Third Decade → Teratoma & Choriocarcinoma. • Forth And Fifth Decade → Seminoma.
  5. 5. Testicular Tumors Tumors Markers: • Alpha Fetoprotein → All Yolk Sac Tumors – 75% Of Embryonal Carcinoma. • Human Chorionic Gonadotrophin (hCG) → All Choriocarcinoma - 60% Embryonal Carcinoma.
  6. 6. Testicular Tumors Spread: • Lymphatic Spread. • Hematogenous Spread. • Local.
  7. 7. Testicular Tumors Clinical: • Asymptomatic. • Mass. • Metastasis. • Hormonal disturbance.
  8. 8. Imaging
  9. 9. Testicular Tumors Plain X-Ray: • Metastasis.
  10. 10. Testicular Tumors CT: • Staging
  11. 11. Testicular Tumors MRI: • Homogeneously hypointense on T2-weighted images. Larger tumors may be more heterogeneous.
  12. 12. Testicular Tumors US: • Hypoechoic relative to the surrounding parenchyma.
  13. 13. Testicular Tumors US: • Seminomas are well defined within the tunica albuginea and homogeneously hypoechoic
  14. 14. Testicular Tumors US: • Nonseminomatous lesions are more often cystic with interspersed areas of calcification.
  15. 15. Testicular Tumors US: • Embryonal cell cancers are heterogeneous. • The borders of the tumor are less distinct. • More aggressive in behavior. • The tunica albuginea may be invaded.
  16. 16. Testicular Tumors US: • Embryonal cell cancers.
  17. 17. Testicular Tumors US: Yolk Sac Tumor: • Imaging findings are nonspecific,especially in children, in whom the only finding may be testicular enlargement without a defined mass.
  18. 18. Testicular Tumors US: Teratoma: • Well-circumscribed complex masses. • Cysts are a common feature and may be anechoic or complex, depending on the cyst contents (ie, serous, mucoid, or keratinous fluid)
  19. 19. Testicular Tumors US: • Choriocarcinomas are often heterogeneous with multiple internal calcifications present.
  20. 20. Testicular Tumors US: • Leydig and Sertoli cell, are generally well defined and hypoechoic. • Calcifications are frequently described.
  21. 21. Testicular Tumors US: • Testicular lymphoma generally appears as discrete hypoechoic lesions, which may completely infiltrate the testicle & epididymis.
  22. 22. Testicular Tumors “Burned-out" Germ Cell Tumor • The patient may present with widespread metastases even though the primary tumor has involuted.
  23. 23. Testicular Tumors “Burned-out" Germ Cell Tumor • The pathogenesis of this phenomenon may be that the high metabolic rate of the tumor causes it to rapidly outgrow its blood supply.
  24. 24. Testicular Tumors “Burned-out" Germ Cell Tumor • These tumors are clinically occult, with the testis being normal to small upon palpation.
  25. 25. Testicular Tumors “Burned-out" Germ Cell Tumor • US plays a vital role in the search for the primary regressed tumor. • These primary tumors have a variable appearance. They are generally small and can be hypoechoic, hyperechoic, or merely an area of focal calcification.

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