Medical Central Resource

Germ Cell Tumor of the Testicle.

Brent Stephenson

8/22/97

Presentation

3 year old male with painless scrotal enlargement.

Imaging Technique

Ultrasound

Imaging Findings

There is a heterogeneous, 2.3 cm mass located centrally within the left testicle. There is a thin rim of normal tissue surrounding the mass and associated hypervascularity of the adjacent tissue.
The right testicle is normal.

Diagnosis

Germ Cell Tumor of the Testicle.

Discussion

Ultrasound of the scrotum can detect intrascrotal masses with a sensitivity approaching 100%. Its accuracy in differentiating intratesticular from extratesticular pathology is 98-100%. This distinction is important because most extratesticular masses are benign, but the majority of intratesticular lesions are malignant.

Testicular neoplasms account for 1-2% of all malignancies in males and is most commonly seen in the 15-34 year age range. Testicular tumors in children (most commonly yolk sac tumor and teratoma) are uncommon representing only 1.5% of all childhood malignancies.

In general, a great majority of patients with a testicular neoplasm present with painless unilateral testicular masses or diffuse testicular enlargement. Risk factors include Caucasian race, Jewish religion, family history, testis maldescent (10 times the risk).

Ninety to ninety-five percent of these neoplasms are of germ cell origin and for the most part are highly malignant. Only 60% of these germ cells tumors are of a single histologic type with the remainder comprised of two or more cell types.

Pathologic Classification: