Scrotum

Malignant lymphoma

1% to 7% of all testicular tumors; most common bilateral secondary testicular neoplasm affecting men > 60 years.

Most common types of germ cell tumors

1. Seminoma 2. Mixed embryonal cell tumors 3. Teratocarcinomas.

Cryptorchidism is bilateral in ___% to ___% of cases.

10%-25%

what increases the incidence of polyorchidism?

Malignancy, cryptorchidism, inguinal hernia, torsion with polyorchidism

germ cell tumor symptoms

Painless lump, testicular enlargement, or vague discomfort in scrotum

most common sites for ectopic testicles to rest

Superficial inguinal pouch. Other sites include perineum, femoral canal, suprapubic area, penis, diaphragm, and other scrotal compartment.

When should testes descend?

Testes should descend into scrotum from inguinal canal shortly before birth or early in neonatal period.

where is testicular duplication found?

Testicular duplication: Usually found in scrotum; has also been found in inguinal canal or retroperitoneum.

Metastasis to testicle is rare, normally occurring later in life.

True

sonographic findings of cryptorchisim

Undescended testis: Smaller and less echogenic than normal testis Usually oval with homogeneous texture Mediastinum rarely seen.

sonographic appearance of choriocarcinoma

varied sonographic appearance because of mixed cell types. Its appearance is determined by the dominant cell type, but it typically has irregular borders.

testicular cancer makes up ____% of cancers in men

1%

germ cell tumors occur most frequently between ages ___ and ____

20-34

Approximately ____% of all testicular tumors are of germ cell type and highly malignant.

95%

metastasis in testicles

Bilateral, with multiple lesions found. Appears as a solid hypoechoic mass, although it has been reported as hyperechoic or a mixture of both.

primary ultrasound goal of germ cell tumor

Determine mass location; differentiate between cystic and solid composition

T/F germ cell tumors are difficult to cure

False--it's one of the most curable forms of cancer

Sonographic appearance of embryonal cell carcinoma

Heterogeneous and less well circumscribed. It may contain areas of increased echogenicity resulting from calcification, hemorrhage, or fibrosis

testicular involvement with leukemia

Leukemia involvement of testicle is next most common secondary testicular neoplasm; most often found in children. Testicle may become enlarged; tumor bilateral or unilateral.

what is anorchism?

Rare condition Unilateral anorchia, or monorchidism, found in 4% of patients with nonpalpable testis. More common on left side; definitive diagnosis depends on surgical diagnosis.

Sonographic Findings of metastasis

Solid hypoechoic mass Hyperechoic Mixture of both

Polyorchidism (testicular duplication)

Very rare disorder; more common on left side (75%); bilateral in 5% of cases Duplicated testis: Usually small; efferent spermatic system completely absent.

Cryptorchidism (Undescended Testicle)

developmental defect in which one or both of the testicles fail to descend into their normal position in the scrotum

T/F Testicular Ectopia is very common

false--it's a very rare condition

T/F non-germ cell tumors are generally malignant

false--they are usually benign

sonographic appearance of germ cell tumors

focal, hypoechoic masses.

categorizations of testicular cancer

germ cell and non-germ cell

most common malignancy in men ages 15-35

germ cell tumor

germ cell tumors are associated with elevated levels of _____ and _____

human chorionic gonadotropin and alpha-fetoprotein

Where might undescended testis be located?

in abdomen, inguinal canal, or other ectopic location. Testis usually found in inguinal canal; often palpable.

causes of anorchism

intrauterine testicular torsion or other forms of decreased vascular supply to testicle in utero.

Where do primary testicular tumors originate from?

may originate from prostate or kidneys; less common sites include lung, pancreas, bladder, colon, thyroid, or melanoma.

Can an ectopic testicle be manipulated into correct path of descent?

no

During fetal growth, where do testes first appear?

retroperitoneum near kidneys.

Embryonal cell tumors are more aggressive than _____

seminomas

sonographic appearance of seminomas

tend to be homogeneous, hypoechoic masses with a smooth border. They do not often contain calcification or cystic components.

T/F extratesticular masses are usually benign

true

T/F intratesticular masses are usually malignant

true

T/F: undescended testis(es) causes an increased risk of cancer

true--they are 2.5-8 times more likely to develop cancer