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AFIP ARCHIVES |
1 From the Departments of Radiologic Pathology (P.J.W.) and Genitourinary Pathology (M.J.O.), Armed Forces Institute of Pathology, 6825 16th St, NW, Bldg 54, Rm M-121, Washington, DC 20306-6000; Department of Radiology, Oregon Health Sciences University, Portland (R.S.); and Department of Radiology, University of Utah, Salt Lake City (D.E.G.). Received July 12, 2001; revision requested August 15 and received September 19; accepted September 20. Address correspondence to P.J.W. (e-mail: woodward@afip.osd.mil).
Testicular carcinoma represents only 1% of all neoplasms in men, but it is the most common malignancy in the 15–34-year-old age group. Germ cell tumors constitute 95% of all testicular tumors. Germ cell tumors are a varied group of neoplasms whose imaging features reflect their underlying histologic characteristics. Seminomas are generally well-defined homogeneous lesions, whereas the nonseminomatous tumors (embryonal carcinoma, yolk sac tumor, choriocarcinoma, teratoma, and mixed germ cell tumor) have a much more varied appearance. Germ cell tumors follow a predictable pattern of spread via the lymphatic drainage to the retroperitoneal nodes. Choriocarcinoma, which has a proclivity for early hematogenous spread, is a notable exception. Testicular tumors may also arise from the sex cords (Sertoli cells) and stroma (Leydig cells). Although 90% of these tumors are benign, there are no reliable imaging criteria to differentiate them from malignant masses. Some benign testicular masses can be recognized, obviating an unwarranted orchiectomy. A dilated rete testis is a normal variant and appears as a series of small tubules near the mediastinum testis. Other benign lesions that can be suspected on the basis of imaging findings and history include intratesticular cysts, epidermoid cysts, congenital adrenal hyperplasia, and sarcoidosis.
© RSNA, 2002
Index Terms: Germ cell neoplasm, 847.313, 847.329 • Seminoma, 847.329 • Teratoma, 847.313 • Testis, cysts, 847.311 • Testis, neoplasms, 847.313, 847.329, 847.34
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