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Ultrasound
Diagnosis
Scrotum
CEUS Scrotum: Malignant Lesions
CEUS Scrotum: Malignant Lesions
Cheng Fang, BSc (Hons), MBBS, FRCR; Gibran Timothy Yusuf, BSc (Hons), MBBS, FRCR; Paul S. Sidhu, BSc, MBBS, MRCP, FRCR, DTM&H
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KEY FACTS

  • US Findings

    • CEUS Findings

      TERMINOLOGY

      • Abbreviations

        • Testicular germ cell tumor (TGCT)
        • Nonseminomatous germ cell tumor (NSGCT)
        • Human chorionic gonadotrophin (HCG)

      • Definitions

        • Nonseminoma is umbrella term describing primary testicular germ tumors, which includes either 1 histologic type, such as embryonal carcinoma, yolk sac tumors, choriocarcinoma, or mixed tumors containing > 1 histologic pattern (of which seminoma is commonly present)
        • Seminoma is classical term to describe pure histologic germ cell tumor
        • Sex cord gonadal stromal tumors account for 1% of primary testicular malignancies and they can be classified based on their cell origins: Leydig cell (from stromal cells), Sertoli cell (sex cord cells) tumors

      PATHOLOGY

      • General Features

        IMAGING

        • General Features

          • US Findings

            • CEUS Findings

              DIFFERENTIAL DIAGNOSIS

              • Testicular Tumors

                Selected References

                1. Konstantatou E et al: Evaluation of intratesticular lesions with strain elastography using strain ratio and color map visual grading: differentiation of neoplastic and nonneoplastic lesions. J Ultrasound Med. ePub, 2018
                2. Rocher L et al: Burned-out testis tumors in asymptomatic infertile men: multiparametric sonography and MRI findings. J Ultrasound Med. 36(4):821-831, 2017
                3. Kühn AL et al: Ultrasonography of the scrotum in adults. Ultrasonography. 35(3):180-97, 2016
                4. Coursey Moreno C et al: Testicular tumors: what radiologists need to know--differential diagnosis, staging, and management. Radiographics. 35(2):400-15, 2015
                5. Sidhu PS: Multiparametric ultrasound (MPUS) imaging: terminology describing the many aspects of ultrasonography. Ultraschall Med. 36(4):315-7, 2015
                6. Sommers D et al: Ultrasonography evaluation of scrotal masses. Radiol Clin North Am. 52(6):1265-81, 2014
                7. Huang DY et al: Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis. Br J Radiol. 85 Spec No 1:S41-53, 2012
                8. Mirochnik B et al: Ultrasound evaluation of scrotal pathology. Radiol Clin North Am. 50(2):317-32, vi, 2012
                9. Lewine D et al: Diagnostic Ultrasound. 4th ed. USA: Elsevier, 2011
                10. Papatsoris AG et al: Leydig cell tumor of the testis. New cases and review of the current literature. Tumori. 90(4):422-3, 2004
                Related Anatomy
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                Related Differential Diagnoses
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                References
                Tables

                Tables

                KEY FACTS

                • US Findings

                  • CEUS Findings

                    TERMINOLOGY

                    • Abbreviations

                      • Testicular germ cell tumor (TGCT)
                      • Nonseminomatous germ cell tumor (NSGCT)
                      • Human chorionic gonadotrophin (HCG)

                    • Definitions

                      • Nonseminoma is umbrella term describing primary testicular germ tumors, which includes either 1 histologic type, such as embryonal carcinoma, yolk sac tumors, choriocarcinoma, or mixed tumors containing > 1 histologic pattern (of which seminoma is commonly present)
                      • Seminoma is classical term to describe pure histologic germ cell tumor
                      • Sex cord gonadal stromal tumors account for 1% of primary testicular malignancies and they can be classified based on their cell origins: Leydig cell (from stromal cells), Sertoli cell (sex cord cells) tumors

                    PATHOLOGY

                    • General Features

                      IMAGING

                      • General Features

                        • US Findings

                          • CEUS Findings

                            DIFFERENTIAL DIAGNOSIS

                            • Testicular Tumors

                              Selected References

                              1. Konstantatou E et al: Evaluation of intratesticular lesions with strain elastography using strain ratio and color map visual grading: differentiation of neoplastic and nonneoplastic lesions. J Ultrasound Med. ePub, 2018
                              2. Rocher L et al: Burned-out testis tumors in asymptomatic infertile men: multiparametric sonography and MRI findings. J Ultrasound Med. 36(4):821-831, 2017
                              3. Kühn AL et al: Ultrasonography of the scrotum in adults. Ultrasonography. 35(3):180-97, 2016
                              4. Coursey Moreno C et al: Testicular tumors: what radiologists need to know--differential diagnosis, staging, and management. Radiographics. 35(2):400-15, 2015
                              5. Sidhu PS: Multiparametric ultrasound (MPUS) imaging: terminology describing the many aspects of ultrasonography. Ultraschall Med. 36(4):315-7, 2015
                              6. Sommers D et al: Ultrasonography evaluation of scrotal masses. Radiol Clin North Am. 52(6):1265-81, 2014
                              7. Huang DY et al: Focal testicular lesions: colour Doppler ultrasound, contrast-enhanced ultrasound and tissue elastography as adjuvants to the diagnosis. Br J Radiol. 85 Spec No 1:S41-53, 2012
                              8. Mirochnik B et al: Ultrasound evaluation of scrotal pathology. Radiol Clin North Am. 50(2):317-32, vi, 2012
                              9. Lewine D et al: Diagnostic Ultrasound. 4th ed. USA: Elsevier, 2011
                              10. Papatsoris AG et al: Leydig cell tumor of the testis. New cases and review of the current literature. Tumori. 90(4):422-3, 2004