title: Testicular tumors: what radiologists need to know--differential diagnosis, staging, and management.
abstract: Cryptorchidism, family history, and infertility are risk factors for testicular cancer. Most testicular cancers occur in young men aged 18-35 years, and seminoma is the most common cell type. Testicular tumors are usually diagnosed at ultrasonography (US) and are staged at computed tomography (CT) or magnetic resonance (MR) imaging. At US, testicular tumors usually appear as a solid intratesticular mass. Because the differential diagnosis includes infarct and infection, correlation with patient history and symptoms is important. At staging CT or MR imaging, retroperitoneal lymph nodes are considered regional lymph nodes, and the greatest nodal diameter is used to distinguish among N1-N3 disease. The right testicular vein drains into the inferior vena cava, and the left testicular vein drains into the left renal vein. Because of venous and lymphatic drainage pathways, retroperitoneal lymph nodes are the initial landing station for testicular cancers. Enlarged lymph nodes in the supraclavicular region, chest, and pelvis are considered distant metastases. Testicular cancer is initially treated with orchiectomy. The patient may then undergo active surveillance, chemotherapy, radiation therapy, or retroperitoneal lymph node resection, depending primarily on the clinical stage. Radiologists play an important role in initial diagnosis, staging, and imaging surveillance of testicular malignancies.
authors.affiliation: From the Departments of Radiology and Imaging Sciences (C.C.M., W.C.S., J.C.C., N.K., P.K.M.), Urology (V.M.), and Pathology (M.L.), Emory University School of Medicine, 1364 Clifton Rd NE, Atlanta, GA 30322; and Department of Radiology, West Penn Allegheny Health System, Pittsburgh, Pa (M.H.).
authors.forename: Courtney
authors.initials: C
authors.lastname: Coursey Moreno
authors.forename: William C
authors.initials: WC
authors.lastname: Small
authors.forename: Juan C
authors.initials: JC
authors.lastname: Camacho
authors.forename: Viraj
authors.initials: V
authors.lastname: Master
authors.forename: Nima
authors.initials: N
authors.lastname: Kokabi
authors.forename: Melinda
authors.initials: M
authors.lastname: Lewis
authors.forename: Matthew
authors.initials: M
authors.lastname: Hartman
authors.forename: Pardeep K
authors.initials: PK
authors.lastname: Mittal
mesh_terms: D000328:Adult; D000368:Aged; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011871:Radiology; D012307:Risk Factors; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult