CT of the chest can hinder the management of seminoma of the testis; it detects irrelevant abnormalities.
To evaluate the role of chest CT in the initial staging of testicular seminomatous germ cell tumours. All patients referred to Addenbrooke's Hospital with testicular seminoma from 1 January 2000 to 31 December 2005 were included and case notes retrospectively reviewed. One hundred and eighty-two patients with testicular seminoma were identified, with a median age of 37 years (range 19-74). Most patients had stage I disease (86%). Twenty-four patients had abnormal abdominal CT findings. One hundred and fifty-eight had normal abdominal CT findings but, on initial staging, chest CT reported abnormalities in 13 patients, which, on further follow-up CT were deemed to be irrelevant to the diagnosis of seminoma. There was a further patient with a normal CT abdomen in whom chest CT detected obvious metastatic disease, which was seen on chest x-ray. Overall 18 cases required additional investigations and follow-up for abnormalities subsequently found to be benign. There was a false-positive rate of 10% for initial staging with chest CT. This is the largest reported series of staging CT chest in testicular seminoma. In all patients with normal abdominal CT, normal chest x-ray and abnormal chest CT, subsequent follow-up investigations demonstrated that the lung lesions were incidental findings.
Horan
G
G
Oncology Department, Box 193, Addenbrooke's Hospital, Hill's Road, Cambridge, CB2 2QQ, UK. ghoran@doctors.org.uk
Rafique
A
A
Robson
J
J
Dixon
A K
AK
Williams
M V
MV
D000328:Adult; D000368:Aged; D005189:False Positive Reactions; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009919:Orchiectomy; D013902:Radiography, Thoracic / Q000379:methods*; D012189:Retrospective Studies; D018239:Seminoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D014057:Tomography, X-Ray Computed / Q000379:methods