Ultrasound morphological patterns of testicular tumours, correlation with histopathology

Martin Necas, Muthappan Muthupalaniappaan, Cecilia Barnard, Martin Necas, Muthappan Muthupalaniappaan, Cecilia Barnard

Abstract

Introduction: Ultrasound (US) plays a key role in the detection of testicular tumours. However, reliable characterisation of testicular tumours with US is difficult. The purpose of this study was to investigate the morphological patterns of testicular tumours as seen on modern US imaging and correlate these with histology.

Methods: The imaging features of 50 testicular tumours were analysed and compared with histology. The US appearance was categorized into 15 distinct morphological patterns.

Results: Patient's age ranged from 0.5 to 85 years. Of the 50 tumours in our series, 49 were malignant. Nearly half of the malignancies were seminomatous germ cell tumours (SGCTs). Tumours ranged in size from 10 to 130 mm with considerable overlap of size between tumours of different histological type. Even small (10 mm) tumours in our cohort were malignant. SGCTs demonstrated a narrower range of morphological appearances than non-seminomatous germ cell tumours (NSGCTs). Calcification was common in both SGCT and NSGCTs. Multicomponent cystic-solid appearance was only seen in NSGCTs.

Conclusion: The differentiation of testicular tumours with US continues to be challenging. In this paper, we have demonstrated the diverse morphological patterns of testicular neoplasms and have proposed the study of tumour morphological features as a promising research direction.

Keywords: Scrotum; testis; tumour; ultrasound.

© 2020 The Authors. Journal of Medical Radiation Sciences published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Medical Imaging and Radiation Therapy and New Zealand Institute of Medical Radiation Technology.

Figures

Figure 1
Figure 1
Number of tumours in different size categories based on visual estimation of tumour volume.
Figure 2
Figure 2
Size distribution of the three most common tumour types.
Figure 3
Figure 3
Morphological patterns of testicular tumours as seen on ultrasound.
Figure 4
Figure 4
Mixed GCT with a sonographically classic appearance of seminoma in the lower pole and distinctly different tumour component (embryonal cell carcinoma) in the upper pole, histologically confirmed.

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