La criptorquidia, historia familiar y la infertilidad son factores de riesgo para cáncer testicular. EL SEMINOMA ES EL TUMOR MÁS FRECUENTE. Ciertos tumores pequeños se diagnostican por Ultrasonido.
Los tumores testiculares suelen aparecer como una masa sólida en el testículo. El diagnóstico diferencial incluye torsión testicular e infección, la historia clínica y los síntomas del paciente son muy importantes.
Para el estadiaje del tumor, recordar que la vena testicular derecha drena en la pared anterior de la vena cava inferior a la altura de L1 y la vena testicular izquierda drena en la vena renal izquierda. Debido al drenaje venoso y linfático, es en estos dos lugares anatómicos donde se deben buscar con especial atención las adenopatías.
Las metástasis pulmonares en “Bola de Cañón” son hematógenas, bastante características de tumores testiculares avanzados.
El cáncer testicular es tratado inicialmente con orquiectomía, si es necesario se prescribe Quimioterapia, Radioterapia o Resección Linfática Retroperitoneal, dependiendo del estadiaje clínico.
El papel de los Radiólogos en el diagnóstico es el estadiaje, el cual se realiza por medio de Tomografía Computarizada, Resonancia Magnética, Pet Scan, debe incluirse las regiones supra claviculares, tórax, abdomen completo incluyendo el tercio proximal de muslos.
La Sociedad Americana de Cáncer estima que en el 2014 se diagnosticaron 8,820 casos, pero solo alrededor de 380 mueren por esta enfermedad.
Este es un artículo de revisión de los departamentos de Radiología, Urología y Patología de la Universidad de Emory, Atlanta y el Hospital West Penn Allegheny, Piptsburgh, Pa. Consta de 87 referencias bibliográficas.
Muy atentamente, equipo TecniScan Científico.
Artículo de Referencia
Testicular Tumors: What Radiologists Need to Know—Differential Diagnosis, Staging, and Management
RadioGraphics 2015; 35:400-415
Abastract
Cryptorchidism, family history, and infertility are risk factors for testicular cancer. Most testicular cancers occur in young men aged 18–35 years, and seminoma is the most common cell type. Testicular tumors are usually diagnosed at ultrasonography (US) and are staged at computed tomography (CT) or magnetic resonance (MR) imaging. At US, testicular tumors usually appear as a solid intratesticular mass. Because the differential diagnosis includes infarct and infection, correlation with patient history and symptoms is important. At staging CT or MR imaging, retroperitoneal lymph nodes are considered regional lymph nodes, and the greatest nodal diameter is used to distinguish among N1–N3 disease. The right testicular vein drains into the inferior vena cava, and the left testicular vein drains into the left renal vein. Because of venous and lymphatic drainage pathways, retroperitoneal lymph nodes are the initial landing station for testicular cancers. Enlarged lymph nodes in the supraclavicular region, chest, and pelvis are considered distant metastases. Testicular cancer is initially treated with orchiectomy. The patient may then undergo active surveillance, chemotherapy, radiation therapy, or retroperitoneal lymph node resection, depending primarily on the clinical stage. Radiologists play an important role in initial diagnosis, staging, and imaging surveillance of testicular malignancies.
Testicular Tumors: What Radiologists Need to Know—Differential Diagnosis, Staging, and Management
RadioGraphics 2015; 35:400-415
Abastract
Cryptorchidism, family history, and infertility are risk factors for testicular cancer. Most testicular cancers occur in young men aged 18–35 years, and seminoma is the most common cell type. Testicular tumors are usually diagnosed at ultrasonography (US) and are staged at computed tomography (CT) or magnetic resonance (MR) imaging. At US, testicular tumors usually appear as a solid intratesticular mass. Because the differential diagnosis includes infarct and infection, correlation with patient history and symptoms is important. At staging CT or MR imaging, retroperitoneal lymph nodes are considered regional lymph nodes, and the greatest nodal diameter is used to distinguish among N1–N3 disease. The right testicular vein drains into the inferior vena cava, and the left testicular vein drains into the left renal vein. Because of venous and lymphatic drainage pathways, retroperitoneal lymph nodes are the initial landing station for testicular cancers. Enlarged lymph nodes in the supraclavicular region, chest, and pelvis are considered distant metastases. Testicular cancer is initially treated with orchiectomy. The patient may then undergo active surveillance, chemotherapy, radiation therapy, or retroperitoneal lymph node resection, depending primarily on the clinical stage. Radiologists play an important role in initial diagnosis, staging, and imaging surveillance of testicular malignancies.
Comité Editorial: Grupo de Radiológicos TecniScan.