Imaging of Bilateral Synchronous Testicular Tumors of Different Histologic Types and Implications for Surgical Management

Bertolotto, Michele; Grenier, N.; Hamm, Bernd; Stocca, Tiziano; Sarocchi, Francesca; Derchi, Lorenzo E.

doi:10.7863/ultra.15.10048

Cited by 5 publications

(2 citation statements)

References 15 publications

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“…It is reported that a lesion presenting on sonography with a hyperechoic and homogeneous pattern is more likely a YST, with teratomas being frequently more echogenic and heterogeneous (17,18). In our case, the patient presented a painless swelling of the right scrotum, with a contralateral undescended testicle.…”

Section: Discussionmentioning

confidence: 62%

Infantile synchronous primary bilateral testicular germ cell tumor: a case report and review of the literature

Zhu¹,

Chen²,

Shen³

et al. 2019

Transl. Androl. Urol.

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Testicular tumors are uncommon in adults, accounting for <1% of all cancers, with testicular germ cell tumors (TGCTs) representing the majority (>95%) of reported cases. Adult and prepubertal TGCTs are fundamentally distinct and the latter is extremely rare, representing 1% of all pediatric solid tumors and having an annual incidence rate of 0.5-2/100,000 boys. Bilateral TGCTs (BTGCTs) account for 0.5-5% of all testicular tumors; the majority are metachronous, while the synchronous account for approximately 0.5-1%. A 16-month-old boy was admitted to our Urology Department with a 2-week history of a painless scrotal mass. Ultrasonography revealed a homogeneous hyperechoic solid mass with rich blood supply in the right testis, and no discernable testicular tissue. A well-delineated heterogeneous echo mass was found within the left testis. Contrast-enhanced computed tomography (CT) scan showed a significantly enhanced mass in the right testis and a mildly enhanced mass in the left testis. Serum alpha-fetoprotein (AFP) was 12,567 ng/mL, while β-human chorionic gonadotrophin (HCG) and total testosterone levels were normal. Accordingly, bilateral testicular tumors were the primary consideration. The patient underwent right radical inguinal orchiectomy with high ligation of the spermatic cord and left testicle-sparing surgery.Final pathology confirmed a pure yolk sac tumor (YST) from the right testis and a cystic mature teratoma from the left. The follow-up ultrasonography showed no recurrence, with serum AFP returned to normal by postoperative day 44. Synchronous primary BTGCT with teratoma and YST respectively can occur coincidently and successfully treated by testicle-sparing surgery.

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Section: Discussionmentioning

confidence: 62%

Infantile synchronous primary bilateral testicular germ cell tumor: a case report and review of the literature

Zhu¹,

Chen²,

Shen³

et al. 2019

Transl. Androl. Urol.

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“…94 In addition, the vascular pattern of intratesticular lesions may suggest their benign or malignant nature. This is important, in particular, in patients with lymphomas or haematological malignancies, 91,92 in patients with bilateral synchronous tumours 95 and in patients with multiple, synchronous lesions in the same testis, in which the therapeutic approach is determined by the most aggressive histotype. 96 However, so far, the assessment of testis vascularisation with CDUS is still qualitative, with no clear quantitative cut-off distinguishing the aforementioned conditions.…”

Section: Testicular Vascularisationmentioning

confidence: 99%

Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal

2021

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Background: Ultrasonography is the gold standard imaging method for scrotal investigation. Colour Doppler ultrasonography, contrast-enhanced ultrasonography and sonoelastography allow sonographers to assess size, echotexture, vascular features and stiffness of the scrotal organs and abnormalities. Scrotal ultrasonography has been used to investigate male reproductive health, scrotal pain, masses and trauma. However, ultrasonography thresholds/classifications used to distinguish normal and pathologic features of the scrotal organs have changed over time, and have not yet been fully standardized. Objectives: To evaluate historical trends for the standards in scrotal ultrasonography:what was, what is and what will be normal.Methods: An extensive Medline search was performed identifying the most relevant studies in the English language from inception to date. Results:We provide here (i) a brief overview of the history of ultrasonography, (ii) current indications for scrotal ultrasonography and (iii) previous and current normal values, cut-offs and classifications of the main colour-Doppler ultrasonography parameters/characteristics of the scrotal organs, as derived from recent guidelines and evidence-based studies. In addition, we report recommendations and the clinical utility of contrast-enhanced ultrasonography and sonoelastography. Finally, we discuss critical issues needing further evidence and future directions to fill in the current gaps.Discussion: Several studies on scrotal ultrasonography are available. However, guidelines/recommendations dealing with specific ultrasonography applications have been published only in recent years. More recently, the European Academy of Andrology published evidence-based scrotal colour-Doppler ultrasonography reference ranges/normative parameters derived from a cohort of healthy, fertile men. In addition, a standardization of the methodology to evaluate qualitative and quantitative colour-Doppler ultrasonography parameters was reported. Other international societies reported indications, methodological standards, clinical utility and limitations of contrast-enhanced ultrasonography and sonoelastography.

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Testis

Bertolotto,

Campo,

Perrone

et al. 2023

Multimodality Imaging and Intervention in Oncology

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Imaging of Bilateral Synchronous Testicular Tumors of Different Histologic Types and Implications for Surgical Management

Cited by 5 publications

References 15 publications

Infantile synchronous primary bilateral testicular germ cell tumor: a case report and review of the literature

Infantile synchronous primary bilateral testicular germ cell tumor: a case report and review of the literature

Historical trends for the standards in scrotal ultrasonography: What was, what is and what will be normal

Testis

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