2004, Number 4
Comparative Study of Ecographic and Histopathologic Findings in Testicular Tumors
Betanzos GC, Castro IM, Manzanilla GHA
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Language: Spanish
References: 16
Page: 271-279
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ABSTRACT
Introduction: Testicle tumors represent 1- 2% of all malignant tumors in males, but they constitute the most frequent malignant neoplasia in young men. Detecting and characterizing scrotal masses has been the most common indication of scrotum ultrasound. The study included 40 subjects clinically and histopathologically diagnosed with testicle neoplasia, who underwent high frequency ultrasound only at grey scale, to then compare the findings and determine the echographic characteristics that are commonly linked based on the histologic lineage of the neoplasias found.Material and Methods: This was a transversal, descriptive, comparativetype study including 40 subjects that had testicle carcinoma diagnosis to be handled with orquiectomy and who underwent high-resolution scrotum ultrasound between January 1 and December 31, 2003. Parameters analyzed were: ultrasound pattern of the lesion, internal echogenicity of the tumor, age, affected side, tumor size, lesion margins, echographic pattern, predominant echographic component type, and, finally, histology variety. Only germ cells tumors were considered, using the World Health Organization classification.
Results: Forty subjects, 29 years old in average that complied with the inclusion criteria were admitted. The histologic type of the tumors found was as follows: 24 cases of pure seminoma (66%), 13 cases of mix germinal tumor (36%), one embrionary carcinoma (3%), one mature teratoma (3%), and one immature teratoma (3%). Seminomas observed were in most cases well delimited lesions (19 of 24) with abundant hipoecoic component (+++). The mix germinal tumor was present as not clearly delimited, heterogeneous lesion in 100% of the cases (13 patients). Embrionary carcinoma showed a complex cystic type component. Both the mature and immature teratoma presented a solid complex component.
Discussion: Currently, scrotum ultrasound is considered as a diagnosis method that is sensitive to detecting testicle neoplasias, even though not very specific. Multiple studies have been required to obtain sufficient solid data to be able to characterize or correlate the echographic aspect with the histologic lineage of each tumor. We support the fact that echographic findings that are most useful are those of the intra-testicular lesion and the parenchyma echogenicity changes. Significant differences were obtained between the seminoma and the mix germinal tumor.
Conclusions: 1.- Ultrasound represents an excellent method for detecting testicle neoplasias. 2.- Echographic findings suggesting testicle neoplasia are changes in the parenchyma echogenicity and the presence of an intra-testicular lesion. 3.- In most cases there were significant differences between seminoma and mix germinal tumor.
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