Tumor-Like Lesions Tumor-Like Lesions of Testisof Testis

Testicular Tumors

Classification:

1. Germ cell tumors (GCTs): (95%) of primary testicular tumors.

a. Seminomas (45%).

b. Non-seminomas (50%): mixed GCTs (40%), Teratomas and teratocarcinomas

(30%) Embryonal cell carcinoma (20%). Choriocarcinoma (1%). Yolk sac

tumors

2. Gonadal Stromal Tumors: Leydig cell tumors and Sertoli cell tumor.

3. Secondary Tumors: Lymphoma, leukemia, and melanoma are the

most common malignancies that metastasize to the testicle.

SeminomasSeminomas

Testicular Tumors

Embryonal Cell Carcinoma

Yolk Sac TumorTeratomaChoriocarcinomasLeydig and Sertoli cell carcinomasLymphoma

Epidermoid Cysts. Epidermoid Cysts.

Testicular Microlithiasis.Testicular Microlithiasis.

Orchitis.Orchitis.

Hemorrhage.Hemorrhage.

Infarction.Infarction.

Granulomatous Orchitis Granulomatous Orchitis (Tuberculosis, Syphilis, Fungi, And Parasites).(Tuberculosis, Syphilis, Fungi, And Parasites).

Tubular Ectasia Of The Rete Testis.Tubular Ectasia Of The Rete Testis.

Testicular Cysts.Testicular Cysts.

Adrenal Rests.Adrenal Rests.

Sarcoidosis.Sarcoidosis.

- Constitute Approximately 1% Of Testicular Tumors.

- Although Pathologically These Lesions Are True Cysts,

They Are Filled With Cheesy Laminated Material That

Appears Solid On Radiologic Images.

US

MRI

- 0.6% of patients.

- Incidental finding.

- The prevalence of carcinoma in patients with

testicular microlithiasis has been reported as high as

40%.

Microcalcifications appear as

laminated concretions within

the lumen of the seminiferous

tubules

Microcalcifications appear as

laminated concretions within

the lumen of the seminiferous

tubules

Multiple pathogens including

tuberculosis, syphilis, fungi,

and parasites may cause a

granulomatous epididymo-

orchitis.

• These processes tend to

involve the epididymis first

and to a much greater extent

than the testis.

• An isolated testicular mass

would be extremely unusual.

• Dilatation of the rete testis is thought to occur

secondary to obstruction in the epididymis or

efferent ductules.

• Tubular ectasia is located posteriorly by the

mediastinum and is composed of a series of

dilated tubules.

• Seen in patients with congenital adrenal hyperplasia and

rarely in those with cushing syndrome.

• These rests are usually less than 5 mm and if these cells

are exposed to elevated levels of adrenocorticotropic

hormone, they can enlarge to form masses.

• Multiple, bilateral, and

eccentrically located.

• Hypoechoic masses or

heterogeneously hyperechoic

masses

• Low Signal Intensity On Both Low Signal Intensity On Both

T1- And T2-weighted ImagesT1- And T2-weighted Images

• Rarely affects the genital tract.Rarely affects the genital tract.

• More commonly affects the epididymis but can, in More commonly affects the epididymis but can, in

some cases, also involve the testis.some cases, also involve the testis.

• Testicular lesions can be solitary, but they are more Testicular lesions can be solitary, but they are more

typically multiple, small, bilateral massestypically multiple, small, bilateral masses