eMedicine Specialties > Radiology > Genitourinary

Testicle, Malignant Tumors: Follow-up

Author: Dawn Light, MD, MPH, Clinical Assistant Professor of Radiology and Pediatrics, Department of Radiology, Consulting Staff, Dayton Children's Medical Center; Clinical Assistant Professor of Radiology, Department of Radiology, Uniformed Services University of the Health Sciences
Contributor Information and Disclosures

Updated: Mar 4, 2009

Intervention

The treatment of testicular cancer is orchiectomy. Ultrasonography is used only to suggest the diagnosis and exclude benign scrotal masses. When testicular malignancy is suspected, the surgeon uses an inguinal approach to avoid contaminating the scrotum. Some institutions are performing testis-sparing procedures when the ultrasonographic findings suggest a benign intratesticular mass such as an epidermoid or a teratoma.14,15

With regard to treatment and adverse effects, radical orchiectomy with ligation of the spermatic cord at the inguinal ring is the recommended surgical procedure for suspected testicular cancer. Infertility may be related to retrograde ejaculation caused by retroperitoneal lymph node dissection or the toxic effects of chemotherapy or radiation therapy. Cisplatin is the mainstay of chemotherapy and is associated with nausea, vomiting, and nephrotoxicity. Hypomagnesemia-induced Raynaud phenomenon is also common.

In adults, even nonaggressive-appearing teratomas are known to develop metastasis. For this reason, careful excision of all teratomas is recommended in adults.

Patient Education: For excellent patient education resources, visit eMedicine's Men's Health Center and Cancer and Tumors Center. Also, see eMedicine's patient education articles Cancer of the Testicle and Testicular Self-Exam.

Medicolegal Pitfalls

  • Tissue diagnosis should be strongly considered in any solid intratesticular mass, especially if a palpable abnormality is present.
 


More on Testicle, Malignant Tumors

Overview: Testicle, Malignant Tumors
Imaging: Testicle, Malignant Tumors
Follow-up: Testicle, Malignant Tumors
Multimedia: Testicle, Malignant Tumors
References
Further Reading
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References

  1. Katiyar RK, Singh A, Kumar D. Primary melanoma of testis. J Cancer Res Ther. Apr-Jun 2008;4(2):97-8. [Medline].

  2. Hersmus R, de Leeuw BH, Wolffenbuttel KP, Drop SL, Oosterhuis JW, Cools M, et al. New insights into type II germ cell tumor pathogenesis based on studies of patients with various forms of disorders of sex development (DSD). Mol Cell Endocrinol. Sep 10 2008;291(1-2):1-10. [Medline].

  3. Looijenga LH, de Munnik H, Oosterhuis JW. A molecular model for the development of germ cell cancer. Int J Cancer. Dec 10 1999;83 (6):809-14. [Medline].

  4. Carmignani L, Bozzini G. Re: Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis. J. D. Raman, C. F. Nobert and M. Goldstein [Letter]. J Urol. Apr 2006;175(4):1574; author reply, 1574.

  5. Bach AM, Hann LE, Hadar O, et al. Testicular microlithiasis: what is its association with testicular cancer?. Radiology. Jul 2001;220(1):70-5. [Medline].

  6. Peterson AC, Bauman JM, Light DE, et al. The prevalence of testicular microlithiasis in an asymptomatic population of men 18 to 35 years old. J Urol. Dec 2001;166(6):2061-4. [Medline].

  7. McKiernan JM, Goluboff ET, Liberson GL, et al. Rising risk of testicular cancer by birth cohort in the United States from 1973 to 1995. J Urol. Aug 1999;162(2):361-3. [Medline].

  8. Taskinen S, Fagerholm R, Aronniemi J, Rintala R, Taskinen M. Testicular tumors in children and adolescents. J Pediatr Urol. Apr 2008;4(2):134-7. [Medline].

  9. Kao HW, Wu CJ, Chen CY, et al. Malignant tumor of testis imitating epididymo-orchitis. Arch Androl. Sep-Oct 2005;51(5):407-11.

  10. Kravets FG, Cohen HL, Sheynkin Y, Sukkarieh T. Intraoperative sonographically guided needle localization of nonpalpable testicular tumors. AJR Am J Roentgenol. Jan 2006;186(1):141-3.

  11. Carmignani L, Morabito A, Gadda F, et al. Prognostic parameters in adult impalpable ultrasonographic lesions of the testicle. J Urol. Sep 2005;174(3):1035-8.

  12. Schwerk WB, Schwerk WN, Rodeck G. Testicular tumors: prospective analysis of real-time US patterns and abdominal staging. Radiology. Aug 1987;164(2):369-74. [Medline].

  13. Cho JH, Chang JC, Park BH, et al. Sonographic and MR imaging findings of testicular epidermoid cysts [comment Dogra V. In. AJR Am J Roentgenol. 2002 Oct;179(4):1075; author reply 1075-6]. AJR Am J Roentgenol. Mar 2002;178(3):743-8. [Medline].

  14. Labarthe P, Khedis M, Chevreau C, Mazerolles C, Thoulouzan M, Durand X, et al. [Management of pure teratoma of the testis in adult, results of a multicenter study over 15 years.]. Prog Urol. Dec 2008;18(13):1075-81. [Medline].

  15. Soh E, Berman LH, Grant JW, Bullock N, Williams MV. Ultrasound-guided core-needle biopsy of the testis for focal indeterminate intratesticular lesions. Eur Radiol. Dec 2008;18(12):2990-6. [Medline].

  16. Austoker J. Screening for ovarian, prostatic, and testicular cancers. Br Med J. Jul 30 1994;309(6950):315-20. [Medline].

  17. Braga FJ, Arbex MA, Haddad J, Maes A. Bone scintigraphy in testicular tumors. Clin Nucl Med. Feb 2001;26(2):117-8. [Medline].

  18. Derogee M, Bevers RF, Prins HJ, et al. Testicular microlithiasis, a premalignant condition: prevalence, histopathologic findings, and relation to testicular tumor. Urology. Jun 2001;57(6):1133-7. [Medline].

  19. Dieckmann KP, Skakkebaek NE. Carcinoma in situ of the testis: review of biological and clinical features. Int J Cancer. Dec 10 1999;83(6):815-22. [Medline].

  20. Doebler RW, Norbut AM. Localized testicular infarction masquerading as a testicular neoplasm. Urology. Aug 1999;54(2):366. [Medline].

  21. Heidenreich A, Weissbach L, Holtl W, et al. Organ sparing surgery for malignant germ cell tumor of the testis. J Urol. Dec 2001;166(6):2161-5. [Medline].

  22. Hurd DS, Olsen T. Cutaneous sarcoidosis presenting as a testicular mass. Cutis. Dec 2000;66(6):435-8. [Medline].

  23. Middleton WD, Teefey SA, Santillan CS. Testicular microlithiasis: prospective analysis of prevalence and associated tumor. Radiology. Aug 2002;224(2):425-8. [Medline].

  24. Resnick MI, Amis ES Jr, Bigongiari LR, et al. Staging of testicular malignancy. American College of Radiology. ACR appropriateness criteria. Radiology. Jun 2000;215 (suppl):741-6. [Medline].

  25. Steinfeld AD. Testicular germ cell tumors: review of contemporary evaluation and management. Radiology. Jun 1990;175(3):603-6. [Medline].

  26. von Eckardstein S, Tsakmakidis G, Kamischke A, et al. Sonographic testicular microlithiasis as an indicator of premalignant conditions in normal and infertile men. J Androl. Sep-Oct 2001;22(5):818-24. [Medline].

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Keywords

malignant testicular tumors, testicular germ cell tumors, germ cell tumors, GCTs, seminomas, nonseminomas, teratomas, teratocarcinomas, testicular metastases, primary testicular tumors, testicular cancer, embryonal cell tumors, choriocarcinomas, yolk sac tumors, endodermal sinus tumors, nongerminal testicular tumors, stromal Leydig cell tumors, Sertoli cell tumors

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Contributor Information and Disclosures

Author

Dawn Light, MD, MPH, Clinical Assistant Professor of Radiology and Pediatrics, Department of Radiology, Consulting Staff, Dayton Children's Medical Center; Clinical Assistant Professor of Radiology, Department of Radiology, Uniformed Services University of the Health Sciences
Dawn Light, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Family Physicians, American College of Radiology, and Phi Beta Kappa
Disclosure: Nothing to disclose.

Medical Editor

Steven Perlmutter, MD, FACR, Associate Professor of Clinical Radiology, School of Medicine at Stony Brook University; Medical Director of Radiology, Peconic Bay Medical Center
Steven Perlmutter, MD, FACR is a member of the following medical societies: American College of Radiology, American Institute of Ultrasound in Medicine, American Medical Association, American Roentgen Ray Society, Association of Program Directors in Radiology, Association of University Radiologists, Medical Society of the State of New York, Radiological Society of North America, Society of Breast Imaging, Society of Nuclear Medicine, and Society of Uroradiology
Disclosure: Nothing to disclose.

Pharmacy Editor

Bernard D Coombs, MB, ChB, PhD, Consulting Staff, Department of Specialist Rehabilitation Services, Hutt Valley District Health Board, New Zealand
Disclosure: Nothing to disclose.

Managing Editor

Joshua A Becker, MD, Professor, Department of Radiology, New York University School of Medicine
Joshua A Becker, MD is a member of the following medical societies: Society of Uroradiology
Disclosure: Nothing to disclose.

CME Editor

Robert M Krasny, MD, Consulting Staff, Department of Radiology, The Angeles Clinic and Research Institute
Robert M Krasny, MD is a member of the following medical societies: American Roentgen Ray Society and Radiological Society of North America
Disclosure: Nothing to disclose.

Chief Editor

Eugene C Lin, MD, Consulting Radiologist, Virginia Mason Medical Center; Clinical Assistant Professor of Radiology, University of Washington School of Medicine
Eugene C Lin, MD is a member of the following medical societies: American College of Nuclear Medicine, American College of Radiology, Radiological Society of North America, and Society of Nuclear Medicine
Disclosure: Nothing to disclose.

 
 
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