Imaging of scrotal masses
- PDF / 3,207,223 Bytes
- 22 Pages / 595.276 x 790.866 pts Page_size
- 102 Downloads / 283 Views
SPECIAL SECTION: MALE PELVIS
Imaging of scrotal masses Kedar G. Sharbidre1 · Mark E. Lockhart1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Testicular cancer is responsible for approximately 0.1% of all cancer deaths in the USA, and seminoma is the most common type of testicular tumor. Ultrasonography is the primary imaging modality for accessing testicular and extratesticular lesions, while magnetic resonance imaging can be used for problem solving in lesion characterization in certain cases. CT imaging is usually performed for retroperitoneal staging of testicular cancer metastasis and follow-up after treatment. Extratesticular masses are common, yet rarely malignant. Imaging plays an important role in primary diagnosis of testicular cancer and differentiating it from common non-neoplastic findings. The purpose of this article is to review various imaging findings in testicular and extratesticular masses. Keywords Testicular · Extratesticular · Ultrasound · Magnetic resonance imaging · Masses · Staging
Introduction Testicular cancer affects men between 15 and 35 years and contributes to 0.1% of all cancer deaths in the USA. Numerous risk factors have been attributed to testicular cancer, including cryptorchidism and Klinefelter syndrome. However, the role of incidentally discovered testicular microlithiasis in the carcinogenesis remains controversial with differing opinions about imaging and follow-up of such patients. Once a testicular mass is detected, guidance for treatment depends upon the underlying lesion classification. A recent WHO classification of testicular tumors, published in 2016, separates testicular tumors based upon their origin from germ cell neoplasia in situ (GCNIS). Seminoma is the most common testicular germ cell tumor. The majority of the extratesticular tumors are benign, with sarcoma as the most common malignancy in this space. Ultrasound (US) remains the primary and best modality to image testicular and extratesticular pathologies due to its lack of use of radiation, high resolution, and real-time assessment of the scrotum with or without the use of Doppler to assess the vascularity. Magnetic resonance imaging (MRI) can serve as adjunctive diagnostic modality to assess * Kedar G. Sharbidre [email protected] 1
scrotal conditions when US findings are indeterminate or when local extent of tumor is to be evaluated. Further imaging including CT can play a pivotal role in assessing the presence and extent of metastases, evaluation for resectability of tumors, surveillance and determination of response to treatment. This article reviews the ultrasound, MRI, and CT imaging of spectrum of scrotal pathologies including benign masses, pseudomasses, and malignant lesions along with brief review of classification and management.
Anatomy Two scrotal sacs are separated by median raphe and each sac contains a testis, epididymis, and spermatic cord. The normal adult testis is covered by a thin tough fibrous capsule, the tunica albuginea, and these are furth
Data Loading...
