Seminoma CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Overview

Abdominal and pelvic CT scans may be diagnostic of seminoma. CT scan may detect metastases of seminoma to the para-aortic, inguinal, or iliac lymph nodes. Visceral metastasis may also be seen.

CT scan may be helpful in the diagnosis of seminoma. Findings on CT scan suggestive seminoma specialy among nonspecific symptoms patients. Abdominal and pelvic CT scans are important in visualizing metastases

CT

• Abdominal and pelvic CT scans are important in visualizing metastases both as a part of primary staging of seminoma and in primary diagnosis when a testicular mass is unknown.
• Metastases to the para-aortic lymph nodes at the level of the renal vessels are the typical first site of spread owing to the lymphatic drainage of the testicles relating to embryological testicular descent. The nodal metastases are often bulky, of homogenous density, and tend to encase surrounding vessels.
• Inguinal or iliac lymph node metastases suggest lymphatic spread via the scrotum and therefore local tumor extension beyond the tunica vaginalis.
• Visceral (distant) metastases are seen in around 5% of patients at presentation (lung, liver, bone, brain). Staging CT of the chest is only indicated when regional para-aortic lymph node spread is present or if there is an abnormal CXR.
• Following therapy, lymph node metastases reduce markedly in size but some inactive abnormal tissue persists which can be difficult to distinguish from residual disease and follow up monitoring is required.
• There are no CT scan findings associated with [disease name]. OR [Location] CT scan may be helpful in the diagnosis of [disease name]. Findings on CT scan suggestive of/diagnostic of [disease name] include:
  • Retroperitoneal lymph nodes
  • Metastases to the para-aortic lymph nodes
    • bulky nodal
    • density homogenous,
    • Tend to encase surrounding vessels
  • and it is the first site of spread lymphatic drainage at the level of the renal vessels )
  • [Finding 3] OR There are no CT scan findings associated with [disease name]. However, a CT scan may be helpful in the diagnosis of complications of [disease name], which include:
  • First site of spread lymphatic drainage of the testicles is para-aortic lymph nodes at the level of the renal vessels
  • [Complication 2]
  • Metastases to the para-aortic lymph nodes until level of renal vessels are the typical first site of spread owing to the lymphatic drainage of the testicles relating to embryological testicular descent. The nodal metastases are often bulky, of homogenous density and tend to encase surrounding vessels.