Testicular Germ Cell Tumours-The Role of Conventional Ultrasound.

Abstract

Simple SummaryTesticular tumours are the most common cancer found in young men, and germ cell tumours account for the majority. This article describes the use of conventional ultrasound in germ cell tumours and how to perform the ultrasound, including how to improve patient position and scanning technique. The classification of germ cell tumours is also provided, and the salient features of different types of tumour are described. Some pitfalls and difficulties of ultrasound are discussed, as well as other uses of ultrasound in this group of patients.Testicular tumours are the most common tumours found in young males and germ cell tumours account for 95% of testicular tumours. Ultrasound is the first-line radiological investigation for imaging of the testis. This article outlines how to undertake an ultrasound examination, including optimal patient position, scanning technique and imaging parameters. Classification of germ cell tumours is provided, and salient imaging features of different tumours are described. Difficulties and pitfalls of ultrasound are described, including tumours found after a trauma presentation, orchitis causing diagnostic difficulties and imaging of small testicular lesions. Other uses of ultrasound are outlined, including looking for a primary testicular tumour following the discovery of retroperitoneal lymph nodes, imaging when tumour-makers increase, local recurrence in the scrotum, and for solid organ biopsy in metastatic disease. Conclusion: Ultrasound remains the first-line of investigation for imaging of the testis, and conventional ultrasound still plays a large role in imaging. On ultrasound alone, accurate morphological characterisation of tumours remains a challenge, despite the imaging features that can be seen in different tumour types. Therefore, histology following orchidectomy of a germ cell tumour remains the gold standard for accurate tumour characterisation.