IS Case 39: Seminoma
Imaging Sciences URMC 2008
Publication Date: 2009-05-19
History
Patient is a 46-year-old male with right testicular pain and swelling for 3 weeks.
Findings
Well-circumscribed, heterogeneously isoechoic to hypoechoic mass in the right testis with vascular flow.
Diagnosis
Discussion
Seminoma is the most common pure germ cell tumor of the testis and accounts for 40%–50% of all germ cell tumors. They occur in slightly older patients than do other testicular neoplasms with a peak incidence in the fourth and fifth decade. The typical presentation is with a self-detected testicular mass that may be associated with pain in the lower abdomen, inguinal region, or scrotum. An estimated 5%–25% of men with testicular seminomas have elevated levels of beta-hCG. The tumor is less aggressive than other testicular neoplasms and is therefore usually confined by the tunica albuginea with only 25% of patients with distant metastases at diagnosis.
Ultrasound typically demonstrates a rounded, well-circumscribed, hypoechoic, and homogeneous mass that does not contain significant cystic or calcific foci. However with high resolution sonography, some seminomas may have a more heterogeneous echotexture.
Seminomas have the most favorable prognosis of the malignant testicular tumors due to its radiosensitivity and chemosensitivity.
References
- Gorman B, Carroll B. The Scrotum. In: Diagnostic Ultrasound, Rumack CM, Wilson SR, Johnson J-A, Charboneau JW (eds), 3rd. Ed., Elsevier Health Sciences, 2005, pp 853-854.
- Adham WK, Raval BK, Uzquiano MC, Lemos LB. Best cases from the AFIP: bilateral testicular tumors: seminoma and mixed germ cell tumor. Radiographics. 2005 May-Jun;25(3):835-9. [PMID: 15888629]
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