STAGING AND FOLLOW-UP STRATEGIES

Size: px
Start display at page:

Download "STAGING AND FOLLOW-UP STRATEGIES"

Transcription

1 ATHENS 4-6 October 2018 European Society of Urogenital Radiology STAGING AND FOLLOW-UP STRATEGIES Ahmet Tuncay Turgut, MD Professor of Radiology Hacettepe University, Faculty of Medicine Ankara 2nd ESUR Teaching Course Multimodality Imaging Approach to Scrotal and Penile Pathologies

2 Testicular Tumor-Management Accurate clinical staging is critical because prognosis and further treatment depends on the clinical stage of the disease...

3 Testicular Tumor-Imaging Identifying tumor Staging disease Detecting recurrence

4 Testicular Tm.-Staging-Requirements To properly stage testicular tumors the following are pre-requisites; Pathology of the tumor specimen History Clinical evaluation Radiological procedure (CT, MRI) Tumor markers (β-hcg, AFP)

5 Testicular Tumor- Staging TNMS system; tumor lymph node metastasis serum tumor marker

6 Moreno et al, Radiographics 2015

7

8 Testicular Tumor- Staging objectives *To detect lymph node metastases in abdomen, thorax and supraclavicular fossa. *To identify lung metastases. *To identify disseminated blood-borne metastatic disease (e.g, in the liver). *To identify brain metastases in selected patients.

9 Testicular Tm.-Staging-Imaging Tools IVU Lymphangiography US CT MRI FDG PET PET/CT Bone scan Chest radiography

10 Staging nodal and metastatic disease Following orchidectomy and an established diagnosis of a testicular germ cell tumour, all patients should have; *Initial staging with CT of chest, abdomen and pelvis. * Subsequently pelvis may be omitted in patients who have had standard inguinal orchidectomy. *In patients who have had a scrotal incision, inguinal hernia repair (where lymphatic drainage may be altered), or in patients who developed testis cancer in an ectopic, undescended testis, the pelvis should be imaged on follow-up examinations.

11 Testicular Tumor-Metastatic spread Route of disease dissemination is via lymphatic to retroperitoneum (except for choriocarcinoma with hematogenous dissemination)

12 Testicular Tumor-Metastatic spread Right testicular tm.- primary drainage Paracaval, precaval, interaortocaval LN Left testicular tm. -primary drainage Para-aortic nodal group Interaortocaval lmphatic spread (Cross-over of lymphatic drainage) in the presence of advanced disease Contralateral met. without involvement of the ipsilateral nodes (unusual)

13 Testicular Tumor-Metastatic spread Nonregional lymph node groups (common iliac, internal iliac, and external iliac nodes, or via the thoracic duct to retrocrural and left supraclavicular nodes) More caudal deposition (external iliac and inguinal lymph nodes) by retrograde spread due to altered lymphatic drainage related to prior scrotal/inguinal surgery

14 Testicular Tumor-Metastatic spread Inguinal lymphadenopathy Scrotal violations Tm.invasion into epididymis, layers of tunica albuginea, skin

15

16 Testicular Tm.-Staging CT of abdomen&pelvis Most common study for assessing retroperitoneum Limitations; Little retroperitoneal fat in young patients Can not detect met. in lymph nodes of normal size Inflammatory LNs vs. enlarged due to malignant disease >1 cm in short axis; highly suspicious for met. (hilar regions of the kidney, para-aortic or caval areas) Cut-off value of cm Short-axis for assessing the likelihood of nodal disease (N0 versus N1 disease); long axis (N1versus N2 and N3 disease)

17 Testicular Tm.-Staging * Brain CT is performed in; symptomatic patients multiple lung metastases very high serum tumour markers (bhcg).

18 31 y.o, metastatic seminoma Moreno et al., Radiographics 2016

19 MGCT (50% teratoma, 45% embryonal carcinoma, 3% yolk sac tumor, 2% choriocarcinoma) Moreno et al., Radiographics 2016

20 Chorioca. metastatic

21 Follow-up- surveillance Surveillance for Stage I disease increasingly recognised as the preferred option for both seminoma and NSGCT Avoids unnecessary treatment in 50 90% of patients and disease-free survival of 98% achieved in patients who relapse on surveillance. Surveillance protocols designed to identify relapse at the earliest stage, thereby enabling earlier treatment. In addition to clinical and serum marker assessment, imaging with CT forms the basis of surveillance strategies.

22 Follow-up- surveillance-nsgct For Stage I, NSGCT surveillance protocols focus on the first year with investigations reducing in intensity in subsequent years. Serum markers checked monthly for the first year, Two monthly chest radiographs and clinical examination, CT scans (abdomen only unless the pelvis is deemed high risk) at 3 months and 1 year Rockall A, Sohaib A. Testicular cancer. In: Nicholson T (ed). Recommendations for cross-sectional imaging in cancer management, Second edition. London: The Royal College of Radiologists, 2014.

23 Follow-up- surveillance-seminoma For seminomas, as serum marker are less reliable, more imaging is used in surveillance with; 6-monthly abdominal CT and chest radiographs for the first 2 years and the pelvis is only imaged if there has been previous pelvic surgery. Annual abdominal CT and chest radiograph are performed until 5 years following the diagnosis. Rockall A, Sohaib A. Testicular cancer. In: Nicholson T (ed). Recommendations for cross-sectional imaging in cancer management, Second edition. London: The Royal College of Radiologists, 2014.

24 Follow-up- surveillance-seminoma Rising tumour marker levels will usually precipitate further imaging to identify metastatic disease or a new primary tumour; This usually requires CT of chest, abdomen and pelvis together with ultrasound of the remaining testicle. If no new disease is seen, an MRI of the brain and/or 18FDG PET-CT is also indicated to detect sites of occult metastatic disease. Rockall A, Sohaib A. Testicular cancer. In: Nicholson T (ed). Recommendations for cross-sectional imaging in cancer management, Second edition. London: The Royal College of Radiologists, 2014.

25 Follow-up for metastatic disease Non-seminomatous. germ cell tumours Residual masses following completion of treatment should be assessed for possible surgical excision in terms of size, precise location and relationship to adjacent structures, including major vessels. 18FDG PET-CT can be used to identify residual active disease in patients with demonstrable residual masses, although mature differentiated teratoma may not be FDG-avid and cannot be excluded with a negative scan. Rockall A, Sohaib A. Testicular cancer. In: Nicholson T (ed). Recommendations for cross-sectional imaging in cancer management, Second edition. London: The Royal College of Radiologists, 2014.

26 Follow-up for metastatic disease Seminomas In general, seminomatous residual masses are not resected because the majority comprise fibrosis and necrosis, with no evidence of active residual malignancy. A negative 18FDG-PET-CT of a residual mass following chemotherapy for seminoma excludes any viable disease. Rockall A, Sohaib A. Testicular cancer. In: Nicholson T (ed). Recommendations for cross-sectional imaging in cancer management, Second edition. London: The Royal College of Radiologists, 2014.

27 Acknowledgement; Dr. Shweta Bhatt

28 Thank you for your attention...

Testicular Malignancies /8/15

Testicular Malignancies /8/15 Collecting Cancer Data: Testis 2014-2015 NAACCR Webinar Series January 8, 2015 Q&A Please submit all questions concerning webinar content through the Q&A panel. Reminder: If you have participants watching

More information

GUIDELINES ON TESTICULAR CANCER

GUIDELINES ON TESTICULAR CANCER 38 (Text updated March 2005) P. Albers (chairman), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, A. Horwich, O. Klepp, M.P. Laguna, G. Pizzocaro Introduction Compared with other types of cancer

More information

Quiz 1. Assign Race 1, Race 2 and Spanish Hispanic Origin to the following scenarios.

Quiz 1. Assign Race 1, Race 2 and Spanish Hispanic Origin to the following scenarios. Quiz 1 Assign Race 1, Race 2 and Spanish Hispanic Origin to the following scenarios. 1. 62 year old Brazilian female Race 1 Race 2 Spanish/Hispanic Origin 2. 43 year old Asian male born in Japan Race 1

More information

Case Scenario 1 Discharge Summary Pathology Report Final Diagnosis: Oncology Consult

Case Scenario 1 Discharge Summary Pathology Report Final Diagnosis: Oncology Consult Case Scenario 1 Discharge Summary A 31-year-old Brazilian male presented with a 6 month history of right-sided scrotal swelling. Backache was present for 2 months and a history of right epididymitis was

More information

Clinical summary. Male 30 year-old with past history of non-seminomous germ cell tumour. Presents with retroperitoneal lymphadenopathy on CT.

Clinical summary. Male 30 year-old with past history of non-seminomous germ cell tumour. Presents with retroperitoneal lymphadenopathy on CT. Clinical summary Male 30 year-old with past history of non-seminomous germ cell tumour. Presents with retroperitoneal lymphadenopathy on CT. For restaging PET/CT. PET/CT findings No significant FDG uptake

More information

Case Scenario 1 Discharge Summary Pathology Report Final Diagnosis: Oncology Consult

Case Scenario 1 Discharge Summary Pathology Report Final Diagnosis: Oncology Consult Case Scenario 1 Discharge Summary A 31-year-old Brazilian male presented with a 6 month history of right-sided scrotal swelling. Backache was present for 2 months and a history of right epididymitis was

More information

Cardiff MRCS OSCE Courses Testicular Cancer

Cardiff MRCS OSCE Courses  Testicular Cancer Testicular Cancer Scenario: A 40-year-old male presents to the surgical out-patient clinic with a 6-8 week history of a painless lump in his left scrotum. He however complains of a dull ache in the scrotum

More information

Exercise. Discharge Summary

Exercise. Discharge Summary Exercise Discharge Summary A 32-year-old Brazilian male presented with a 6 month history of right-sided scrotal swelling. Backache was present for 2 months and a history of right epididymitis was present

More information

Testicular Cancer. Regional Follow-up Guidelines

Testicular Cancer. Regional Follow-up Guidelines Urological Cancers Managed Clinical Network Testicular Cancer Regional Follow-up Guidelines Prepared by Drs J White/ A Waterston, J Salmond, J Wallace, Mr D Hendry, Approved by Urological Cancers MCN and

More information

Doppler ultrasound of the abdomen and pelvis, and color Doppler

Doppler ultrasound of the abdomen and pelvis, and color Doppler - - - - - - - - - - - - - Testicular tumors are rare in children. They account for only 1% of all pediatric solid tumors and 3% of all testicular tumors [1,2]. The annual incidence of testicular tumors

More information

EAU GUIDELINES ON TESTICULAR CANCER

EAU GUIDELINES ON TESTICULAR CANCER EAU GUIDELINES ON TESTICULAR CANCER (Limited text update March 2015) P. Albers (Chair), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, K. Fizazi, A. Horwich, M.P. Laguna, N. Nicolai, J. Oldenburg

More information

Collecting Cancer Data: Testis 2/3/11. Collecting Cancer Data: NAACCR Webinar Series 1. Agenda. Fabulous Prizes

Collecting Cancer Data: Testis 2/3/11. Collecting Cancer Data: NAACCR Webinar Series 1. Agenda. Fabulous Prizes Collecting Cancer Data: Testis February 3, 2011 NAACCR 2010-2011 Webinar Series Agenda Coding moment Race/Hispanic origin Overview Collaborative Stage Treatment Exercises Fabulous Prizes NAACCR 2010-2011

More information

Testicular germ cell tumors

Testicular germ cell tumors Testicular germ cell tumors Introduction Most common solid tumor in young adult men with 3 6 new cases/100,000 men/year. They acc ount for 1.5% of male malignancies and 5% of urological tumors. Bilateral

More information

EAU GUIDELINES ON TESTICULAR CANCER

EAU GUIDELINES ON TESTICULAR CANCER EAU GUIDELINES ON TESTICULAR CANCER (Limited text update March 2018) P. Albers (Chair), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, K. Fizazi, A. Horwich, M.P. Laguna (Vice-chair), N. Nicolai,

More information

Resection of retroperitoneal residual mass after chemotherapy in patients with nonseminomatous testicular cancer

Resection of retroperitoneal residual mass after chemotherapy in patients with nonseminomatous testicular cancer Turkish Journal of Cancer Vol.31/ No. 2/2001 Resection of retroperitoneal residual mass after chemotherapy in patients with nonseminomatous testicular cancer AHMET ÖZET 1, ALİ AYDIN YAVUZ 1, MURAT BEYZADEOĞLU

More information

Radiology- Pathology Conference 4/29/2012. Lymph Nodes. John McGrath

Radiology- Pathology Conference 4/29/2012. Lymph Nodes. John McGrath Radiology- Pathology Conference 4/29/2012 Lymph Nodes John McGrath 1 Presentation material is for education purposes only. All rights reserved. 2012 URMC Radiology Page 1 of 24 Case 1: 51 year-old male

More information

Prof. Dr. med. Beata BODE-LESNIEWSKA Institute of Pathology and Molecular Pathology University Hospital; Zurich

Prof. Dr. med. Beata BODE-LESNIEWSKA Institute of Pathology and Molecular Pathology University Hospital; Zurich Prof. Dr. med. Beata BODE-LESNIEWSKA Institute of Pathology and Molecular Pathology University Hospital; Zurich 32 year old man 2 months history of growing left supraclavicular lymph nodes Antibiotic treatment

More information

GUIDELINES FOR CANCER IMAGING Lung Cancer

GUIDELINES FOR CANCER IMAGING Lung Cancer GUIDELINES FOR CANCER IMAGING Lung Cancer Greater Manchester and Cheshire Cancer Network Cancer Imaging Cross-Cutting Group April 2010 1 INTRODUCTION This document is intended as a ready reference for

More information

ASYMPTOMATIC COMPLEX TESTICULAR NEOPLASIA ASSOCIATED WITH ORCHIEPIDIDYMITIS. CASE REPORT

ASYMPTOMATIC COMPLEX TESTICULAR NEOPLASIA ASSOCIATED WITH ORCHIEPIDIDYMITIS. CASE REPORT Rev. Med. Chir. Soc. Med. Nat., Iaşi 2017 vol. 121, no. 4 SURGERY CASE REPORTS ASYMPTOMATIC COMPLEX TESTICULAR NEOPLASIA ASSOCIATED WITH ORCHIEPIDIDYMITIS. CASE REPORT Ș. Iacob 1, R. Vrînceanu 2,3, B.

More information

Teratocarcinoma In A Young Boy- An Unusual Presentation

Teratocarcinoma In A Young Boy- An Unusual Presentation Human Journals Case Report November 2015 Vol.:2, Issue:1 All rights are reserved by Atia Zaka-ur-Rab et al. Teratocarcinoma In A Young Boy- An Unusual Presentation Keywords: Boy, Testicular Mass, Teratocarcinoma

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Renal and adrenal tumours Faculty of Clinical Radiology www.rcr.ac.uk Contents Renal cell carcinoma 3 Clinical

More information

GERM-CELL TUMOURS. ESMO Preceptorship on Adolescents and Young Adults with cancer Lugano, May 2018

GERM-CELL TUMOURS. ESMO Preceptorship on Adolescents and Young Adults with cancer Lugano, May 2018 ESMO Preceptorship on Adolescents and Young Adults with cancer Lugano, 11-12 May 2018 GERM-CELL TUMOURS Giannis Mountzios MSc, PhD Medical Oncology University of Athens School of Medicine Athens, Greece

More information

EAU GUIDELINES ON TESTICULAR CANCER

EAU GUIDELINES ON TESTICULAR CANCER EU GUIDELINES ON TESTICULR CNCER (Limited text update March 2017) P. lbers (Chair), W. lbrecht, F. lgaba, C. Bokemeyer, G. Cohn-Cedermark, K. Fizazi,. Horwich, M.P. Laguna, N. Nicolai, J. Oldenburg Introduction

More information

Guidelines on Testicular Cancer

Guidelines on Testicular Cancer Guidelines on Testicular Cancer P. Albers (chairman), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, K. Fizazi, A. Horwich, M.P. Laguna European Association of Urology 2009 TABLE OF CONTENTS

More information

Testis. Protocol applies to all malignant germ cell and malignant sex cord-stromal tumors of the testis, exclusive of paratesticular malignancies.

Testis. Protocol applies to all malignant germ cell and malignant sex cord-stromal tumors of the testis, exclusive of paratesticular malignancies. Testis Protocol applies to all malignant germ cell and malignant sex cord-stromal tumors of the testis, exclusive of paratesticular malignancies. Protocol revision date: January 2005 Based on AJCC/UICC

More information

NICaN Testicular Germ Cell Tumours SACT protocols

NICaN Testicular Germ Cell Tumours SACT protocols Reference No: Title: Author(s) Ownership: Approval by: Systemic Anti-Cancer Therapy (SACT) Guidelines for Germ Cell Tumours Dr Audrey Fenton Consultant Medical Oncologist, Dr Vicky Coyle Consultant Medical

More information

ANZUP SURVEILLANCE RECOMMENDATIONS FOR METASTATIC TESTICULAR CANCER POST-CHEMOTHERAPY

ANZUP SURVEILLANCE RECOMMENDATIONS FOR METASTATIC TESTICULAR CANCER POST-CHEMOTHERAPY ANZUP SURVEILLANCE RECOMMENDATIONS FOR METASTATIC TESTICULAR CANCER POST-CHEMOTHERAPY Note: These surveillance recommendations are provided as recommendations only. Clinicians should take into account

More information

-The cause of testicular neoplasms remains unknown

-The cause of testicular neoplasms remains unknown - In the 15- to 34-year-old age group, they are the most common tumors of men. - include: I. Germ cell tumors : (95%); all are malignant. II. Sex cord-stromal tumors: from Sertoli or Leydig cells; usually

More information

Testicular Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version December 8, NCCN.org.

Testicular Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version December 8, NCCN.org. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 2.2017 December 8, 2016 NCCN.org Continue Version 2.2017, 12/08/16 National Comprehensive Cancer Network, Inc. 2016, All rights

More information

GUIDELINES ON TESTICULAR CANCER

GUIDELINES ON TESTICULAR CANCER European Association of Urology GUIDELINES ON TESTICULAR CANCER P. Albers (chairman), W. Albrecht, F. Algaba, C. Bokemeyer, G. Cohn-Cedermark, A. Horwich, O. Klepp, M.P. Laguna, G. Pizzocaro UPDATE MARCH

More information

Citation for published version (APA): Lutke Holzik, M. F. (2007). Genetic predisposition to testicular cancer s.n.

Citation for published version (APA): Lutke Holzik, M. F. (2007). Genetic predisposition to testicular cancer s.n. University of Groningen Genetic predisposition to testicular cancer Lutke Holzik, Martijn Frederik IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite

More information

BENIGN & MALIGNANT TESTIS DISEASES. Gary J. Faerber, M.D. Associate Professor, Dept of Urology March 2009 OBJECTIVES

BENIGN & MALIGNANT TESTIS DISEASES. Gary J. Faerber, M.D. Associate Professor, Dept of Urology March 2009 OBJECTIVES BENIGN & MALIGNANT TESTIS DISEASES Gary J. Faerber, M.D. Associate Professor, Dept of Urology March 2009 OBJECTIVES 1. Become familiar with the scrotal contents and their anatomical relationship with each

More information

Oncology General Principles L A U R I E S I M A R D B R E A S T S U R G I C A L O N C O L O G Y F E L L O W D E C E M B E R

Oncology General Principles L A U R I E S I M A R D B R E A S T S U R G I C A L O N C O L O G Y F E L L O W D E C E M B E R Oncology General Principles L A U R I E S I M A R D B R E A S T S U R G I C A L O N C O L O G Y F E L L O W D E C E M B E R 2 0 1 2 Objectives Discuss Diagnostic and staging strategies in oncology Know

More information

IMAGING GUIDELINES - COLORECTAL CANCER

IMAGING GUIDELINES - COLORECTAL CANCER IMAGING GUIDELINES - COLORECTAL CANCER DIAGNOSIS The majority of colorectal cancers are diagnosed on colonoscopy, with some being diagnosed on Ba enema, ultrasound or CT. STAGING CT chest, abdomen and

More information

Male Genital Cancers in the US in Frequency of Types

Male Genital Cancers in the US in Frequency of Types Germ Cell Tumors of the Testis Pathology, Immunohistochemistry, and the Often Confusing Appearance of Their Metastases Charles Zaloudek, MD Department of Pathology UCSF Male Genital Cancers in the US in

More information

Take Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules

Take Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules Take Home Quiz 1 Please complete the quiz below prior to the session. Use the Multiple Primary and Histology Rules Case 1 72 year old white female presents with a nodular thyroid. This was biopsied in

More information

Ultrasound of malignant testicular lesions. Arne Hørlyck Department of Radiology Aarhus University Hospital, Skejby

Ultrasound of malignant testicular lesions. Arne Hørlyck Department of Radiology Aarhus University Hospital, Skejby Ultrasound of malignant testicular lesions Arne Hørlyck Department of Radiology Aarhus University Hospital, Skejby Testis Ultrasound is fantastic!! Scrotum Extratesticular mass: Benign Intratesticular

More information

Note: The cause of testicular neoplasms remains unknown

Note: The cause of testicular neoplasms remains unknown - In the 15- to 34-year-old age group, they are the most common tumors of men. - Tumors of the testis are a heterogeneous group of neoplasms that include: I. Germ cell tumors : 95%; all are malignant.

More information

Testicular Germ Cell Cancer Explained

Testicular Germ Cell Cancer Explained The Beatson West of Scotland Cancer Centre Pan Glasgow Urology / Oncology Patient Information Testicular Germ Cell Cancer Explained The Beatson West of Scotland Cancer Centre 1053 Great Western Road, Glasgow

More information

It is known, from comparisons of lymphography. with lymph-node histology, that 250 of clinical Stage I patients have

It is known, from comparisons of lymphography. with lymph-node histology, that 250 of clinical Stage I patients have Br. J. ('ancer (1982) 45, 167 PROGNOSTIC FACTORS IN CLINICAL STAGE I NON-SEMINOMATOUS GERM-CELL TUMOURS OF THE TESTIS D. RAGHAVAN*, M. J. PECKHAM, E. HEYDERMANt, J. S. TOBIAS AND D. E. AUSTIN From, the

More information

COLORECTAL CANCER STAGING in 2010

COLORECTAL CANCER STAGING in 2010 COLORECTAL CANCER STAGING in 2010 Robert A. Halvorsen, MD, FACR MCV Hospitals / VCU Medical Center Richmond, Virginia I do not have any relevant financial relationships with any commercial interests COLON

More information

GUIDELINES FOR THE MANAGEMENT OF UROLOGICAL CANCER

GUIDELINES FOR THE MANAGEMENT OF UROLOGICAL CANCER GUIDELINES FOR THE MANAGEMENT OF UROLOGICAL CANCER Testicular Tumour Treatment Guidelines Authors: Professor Peter Clark Mr Mark Fordham Review Date: May 2017 CONTENTS Page 1. Introduction 4 2. Details

More information

Lung Cancer Imaging. Terence Z. Wong, MD,PhD. Department of Radiology Duke University Medical Center Durham, NC 9/9/09

Lung Cancer Imaging. Terence Z. Wong, MD,PhD. Department of Radiology Duke University Medical Center Durham, NC 9/9/09 Lung Cancer Imaging Terence Z. Wong, MD,PhD Department of Radiology Duke University Medical Center Durham, NC 9/9/09 Acknowledgements Edward F. Patz, Jr., MD Jenny Hoang, MD Ellen L. Jones, MD, PhD Lung

More information

FDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave

FDG PET/CT STAGING OF LUNG CANCER. Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER Dr Shakher Ramdave FDG PET/CT STAGING OF LUNG CANCER FDG PET/CT is used in all patients with lung cancer who are considered for curative treatment to exclude occult disease.

More information

Metastasis of Testicular Carcinoma in The Inguinal Region

Metastasis of Testicular Carcinoma in The Inguinal Region CASE REPORT Agus Rizal AH Hamid, Rainy Umbas Department of Urology, Faculty of Medicine, University of Indonesia - dr. Cipto Mangunkusumo Hospital. Jl. Diponegoro no. 71, Jakarta Pusat. Correspondence

More information

Male genital tract tumors. SiCA. Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital.

Male genital tract tumors. SiCA. Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital. Male genital tract tumors Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital. adenocarcinoma Prostate Cancer most common male cancer in western countries more detected in

More information

Clinical Diagnosis. your PR.i.VATES.

Clinical Diagnosis. your PR.i.VATES. your PR.i.VATES Clinical Diagnosis What is an orchidectomy? What to expect after orchidectomy Results and Confirmed Diagnosis What is the lymphatic system? www.yourprivates.org.uk CONTENTS CLINICAL DIAGNOSIS

More information

Atlas of Lymph Node Anatomy

Atlas of Lymph Node Anatomy Atlas of Lymph Node Anatomy Mukesh G. Harisinghani Editor Atlas of Lymph Node Anatomy This publication was developed through an unrestricted educational grant from Siemens. Editor Mukesh G. Harisinghani

More information

Newcastle HPB MDM updated radiology imaging protocol recommendations. Author Dr John Scott. Consultant Radiologist Freeman Hospital

Newcastle HPB MDM updated radiology imaging protocol recommendations. Author Dr John Scott. Consultant Radiologist Freeman Hospital Newcastle HPB MDM updated radiology imaging protocol recommendations Author Dr John Scott. Consultant Radiologist Freeman Hospital This document is intended as a guide to aid radiologists and clinicians

More information

Running Title: Utility of HCG Washout in Cervical LND FNA

Running Title: Utility of HCG Washout in Cervical LND FNA AACE Clinical Case Reports Rapid Electronic Articles in Press Rapid Electronic Articles in Press are preprinted manuscripts that have been reviewed and accepted for publication, but have yet to be edited,

More information

THE ROLE OF CONTEMPORARY IMAGING AND HYBRID METHODS IN THE DIAGNOSIS OF CUTANEOUS MALIGNANT MELANOMA(CMM) AND MERKEL CELL CARCINOMA (MCC)

THE ROLE OF CONTEMPORARY IMAGING AND HYBRID METHODS IN THE DIAGNOSIS OF CUTANEOUS MALIGNANT MELANOMA(CMM) AND MERKEL CELL CARCINOMA (MCC) THE ROLE OF CONTEMPORARY IMAGING AND HYBRID METHODS IN THE DIAGNOSIS OF CUTANEOUS MALIGNANT MELANOMA(CMM) AND MERKEL CELL CARCINOMA (MCC) I.Kostadinova, Sofia, Bulgaria CMM some clinical facts The incidence

More information

ESMO Consensus Empfehlungen 2017

ESMO Consensus Empfehlungen 2017 ESMO Consensus Empfehlungen 2017 What s old, what s new, what s missing? Jörg Beyer, Klinik für Onkologie Offenlegung Interessenskonflikte 1. Anstellungsverhältnis oder Führungsposition Keine 2. Beratungs-

More information

Radiological staging of lung cancer. Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh

Radiological staging of lung cancer. Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh Radiological staging of lung cancer Shukri Loutfi,MD,FRCR Consultant Thoracic Radiologist KAMC-Riyadh Bronchogenic Carcinoma Accounts for 14% of new cancer diagnoses in 2012. Estimated to kill ~150,000

More information

Pelvic tumor in childhood Classification, imaging approach and radiological findings

Pelvic tumor in childhood Classification, imaging approach and radiological findings Pelvic tumor in childhood Classification, imaging approach and radiological findings M. Mearadji International Foundation for Pediatric Imaging Aid Rotterdam, The Netherlands Solid pelvic masses in childhood

More information

Case Report Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass

Case Report Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular Mass Case Reports in Urology Volume 2015, Article ID 835962, 4 pages http://dx.doi.org/10.1155/2015/835962 Case Report Seminoma Presenting as Renal Mass, Inferior Vena Caval Thrombus, and Regressed Testicular

More information

What is Testicular cancer?

What is Testicular cancer? Testicular Cancer What is Testicular cancer? Testicular cancer is a disease in which cancer cells form in the tissues of one or both testicles. The testicles are 2 egg-shaped glands located inside the

More information

MULTIDISCIPLINARY GENITOURINARY ONCOLOGY COURSE

MULTIDISCIPLINARY GENITOURINARY ONCOLOGY COURSE MULTIDISCIPLINARY GENITOURINARY ONCOLOGY COURSE Case 2 Testicular Cancer Nuno Sineiro Vau Medical Oncologist Champalimaud Foundation, Lisbon October 2017 Male, 36 year-old, sales manager. Past medical

More information

Cancers of unknown primary : Knowing the unknown. Prof. Ahmed Hossain Professor of Medicine SSMC

Cancers of unknown primary : Knowing the unknown. Prof. Ahmed Hossain Professor of Medicine SSMC Cancers of unknown primary : Knowing the unknown Prof. Ahmed Hossain Professor of Medicine SSMC Definition Cancers of unknown primary site (CUPs) Represent a heterogeneous group of metastatic tumours,

More information

Aggressive Slurgical Management of Testicular Carcinoma Metastatic to Lungs and Mediastinurn

Aggressive Slurgical Management of Testicular Carcinoma Metastatic to Lungs and Mediastinurn Aggressive Slurgical Management of Testicular Carcinoma Metastatic to Lungs and Mediastinurn Isadore Mandelbaum, M.D., Stephen D. Williams, M.D., and Lawrence H. Einhorn, M.D. ABSTRACT During the past

More information

Essentials of Clinical MR, 2 nd edition. 73. Urinary Bladder and Male Pelvis

Essentials of Clinical MR, 2 nd edition. 73. Urinary Bladder and Male Pelvis 73. Urinary Bladder and Male Pelvis Urinary bladder carcinoma is best locally staged with MRI. It is important however to note that a thickened wall (> 5 mm) is a non-specific finding seen in an underfilled

More information

Role and extension of lymph node dissection in kidney, bladder and prostate cancer. Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017

Role and extension of lymph node dissection in kidney, bladder and prostate cancer. Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017 Role and extension of lymph node dissection in kidney, bladder and prostate cancer Omar Ghanem (PGY3 ) Moderator: Dr A. Noujem 30 th March 2017 Bladder Cancer LN dissection in Bladder cancer 25% of patients

More information

Leukaemia 35% Lymphoma 14%

Leukaemia 35% Lymphoma 14% Distribution ib ti of Cancers in Children under 15 years Leukaemia 35% Lymphoma 14% Neuroblastoma 9% Other 5% Liver 1% Retinoblastoma 3% Bone and STS 15% CNS 20% Wilms' 8% 30-40% Mortality Germ Cell Tumours

More information

Surgery Illustrated Surgical Atlas Inguinal orchidectomy for testicular cancer

Surgery Illustrated Surgical Atlas Inguinal orchidectomy for testicular cancer Surgery Illustrated Focus on Details SURGERY ILLUSTRATED SURGICAL ATLASPIZZOCARO and GUARNERI PIZZOCARO and GUARNERI BJUI BJU INTERNATIONAL Surgery Illustrated Surgical Atlas Inguinal orchidectomy for

More information

For more information about how to cite these materials visit

For more information about how to cite these materials visit Author(s): Gary Faerber, M.D., 2011 License: Unless otherwise noted, this material is made available under the terms of the Creative Commons Attribution Share Alike 3.0 License: http://creativecommons.org/licenses/by-sa/3.0/

More information

Gynecologic Cancer Surveillance and Survivorship: Informing Practice and Policy

Gynecologic Cancer Surveillance and Survivorship: Informing Practice and Policy Gynecologic Cancer Surveillance and Survivorship: Informing Practice and Policy Stephanie Yap, M.D. University Gynecologic Oncology Northside Cancer Institute Our Learning Objectives Review survival rates,

More information

Imaging of the cisterna chyli on PET-CT in patients with known malignancy: Report of two cases

Imaging of the cisterna chyli on PET-CT in patients with known malignancy: Report of two cases Imaging of the cisterna chyli on PET-CT in patients with known malignancy: Report of two cases Natalie Burns, B.S., Jason Barksdale, M.D., Linh Ho, M.D., and Patrick M. Colletti, M.D. Citation: Burns N,

More information

Testicular Cancer: radiopathological correlation of testicular tumors in adulthood population. A review of 32 cases.

Testicular Cancer: radiopathological correlation of testicular tumors in adulthood population. A review of 32 cases. Testicular Cancer: radiopathological correlation of testicular tumors in adulthood population. A review of 32 cases. Poster No.: C-1085 Congress: ECR 2015 Type: Educational Exhibit Authors: R. Miranda;

More information

Uncommon secondary tumour of the stomach

Uncommon secondary tumour of the stomach Uncommon secondary tumour of the stomach B. Bancel, Hôpital CROIX ROUSSE LYON Bucharest Nov 2013 Case report 33-year old man Profound mental retardation and motor disturbances (sequelae of neonatal meningeal

More information

Staging Colorectal Cancer

Staging Colorectal Cancer Staging Colorectal Cancer CT is recommended as the initial staging scan for colorectal cancer to assess local extent of the disease and to look for metastases to the liver and/or lung Further imaging for

More information

Ines Buccimazza 16 TH UP CONTROVERSIES AND PROBLEMS IN SURGERY SYMPOSIUM

Ines Buccimazza 16 TH UP CONTROVERSIES AND PROBLEMS IN SURGERY SYMPOSIUM BILATERAL MASTECTOMY IS NOT ROUTINELY JUSTIFIED IN PATIENTS WITH BILATERAL AXILLARY LYMPHADENOPATHY AND ONLY ONE DETECTABLE PRIMARY BREAST CANCER LESION SURGERY SYMPOSIUM Ines Buccimazza Breast Unit Department

More information

Karoline Nowillo, MD. February 1, 2008

Karoline Nowillo, MD. February 1, 2008 Case Presentation Karoline Nowillo, MD SUNY Downstate t February 1, 2008 Case Presentation Chief complaint enlarging goiter x 8 months History of present illness shortness of breath, heaviness in chest

More information

Recommendations for cross-sectional imaging in cancer management, Second edition

Recommendations for cross-sectional imaging in cancer management, Second edition www.rcr.ac.uk Recommendations for cross-sectional imaging in cancer management, Second edition Carcinoma of unknown primary origin (CUP) Faculty of Clinical Radiology www.rcr.ac.uk Contents Carcinoma of

More information

Testicular leydig cell tumor with metachronous lesions: Outcomes after metastasis resection and cryoablation

Testicular leydig cell tumor with metachronous lesions: Outcomes after metastasis resection and cryoablation Washington University School of Medicine Digital Commons@Becker Open Access Publications 2015 Testicular leydig cell tumor with metachronous lesions: Outcomes after metastasis resection and cryoablation

More information

Testicular Cancer. J. Richard Auman, MD. James J. Stark, MD. Jerry Singer, MD. September 19, 2008

Testicular Cancer. J. Richard Auman, MD. James J. Stark, MD. Jerry Singer, MD. September 19, 2008 Testicular Cancer J. Richard Auman, MD James J. Stark, MD Jerry Singer, MD September 19, 2008 Testicular Cancer From mystery to far-advanced disease: a remarkable case Case Presentation. 23 y. o. male

More information

performed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management.

performed to help sway the clinician in what the appropriate diagnosis is, which can substantially alter the treatment of management. Hello, I am Maura Polansky at the University of Texas MD Anderson Cancer Center. I am a Physician Assistant in the Department of Gastrointestinal Medical Oncology and the Program Director for Physician

More information

Lymphoma Read with the experts

Lymphoma Read with the experts Lymphoma Read with the experts Marc Seltzer, MD Associate Professor of Radiology Geisel School of Medicine at Dartmouth Director, PET-CT Course American College of Radiology Learning Objectives Recognize

More information

Endobronchial Ultrasound in the Diagnosis & Staging of Lung Cancer

Endobronchial Ultrasound in the Diagnosis & Staging of Lung Cancer Endobronchial Ultrasound in the Diagnosis & Staging of Lung Cancer Dr Richard Booton PhD FRCP Lead Lung Cancer Clinician, Consultant Respiratory Physician & Speciality Director Manchester University NHS

More information

Case Report Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass

Case Report Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass Hindawi Volume 2017, Article ID 4529853, 4 pages https://doi.org/10.1155/2017/4529853 Case Report Primary Malignancy in a Supernumerary Testicle Presenting as a Large Pelvic Mass Justin Noroozian, 1 Daniel

More information

Testicular Cancer: Questions and Answers. Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles.

Testicular Cancer: Questions and Answers. Testicular cancer is a disease in which cells become malignant (cancerous) in one or both testicles. CANCER FACTS N a t i o n a l C a n c e r I n s t i t u t e N a t i o n a l I n s t i t u t e s o f H e a l t h D e p a r t m e n t o f H e a l t h a n d H u m a n S e r v i c e s Testicular Cancer: Questions

More information

The Metastatic Tumor after Testicular Cancer case presentation has been conducted by the Faradarmani and Psymentology group under provision of Dr.

The Metastatic Tumor after Testicular Cancer case presentation has been conducted by the Faradarmani and Psymentology group under provision of Dr. The Metastatic Tumor after Testicular Cancer case presentation has been conducted by the Faradarmani and Psymentology group under provision of Dr. M.A Taheri the founder of Faradarmani and Psymentology.

More information

Extratesticular Extension of Germ Cell Tumors Preferentially Occurs at the Hilum

Extratesticular Extension of Germ Cell Tumors Preferentially Occurs at the Hilum Anatomic Pathology / EXTRATESTICULAR EXTENSION OF GERM CELL TUMORS Extratesticular Extension of Germ Cell Tumors Preferentially Occurs at the Hilum Sarah M. Dry, MD, and Andrew A. Renshaw, MD Key Words:

More information

GROUP 1: Peripheral tumour with normal hilar and mediastinum on staging CT with no disant metastases. Including: Excluding:

GROUP 1: Peripheral tumour with normal hilar and mediastinum on staging CT with no disant metastases. Including: Excluding: GROUP 1: Including: Excluding: Peripheral tumour with normal hilar and mediastinum on staging CT with no disant metastases Solid pulmonary nodules 8mm diameter / 300mm3 volume and BROCK risk of malignancy

More information

North of Scotland Cancer Network Clinical Management Guideline for Carcinoma of the Uterine Cervix

North of Scotland Cancer Network Clinical Management Guideline for Carcinoma of the Uterine Cervix THIS DOCUMENT North of Scotland Cancer Network Carcinoma of the Uterine Cervix UNCONTROLLED WHEN PRINTED DOCUMENT CONTROL Prepared by A Kennedy/AG Macdonald/Others Approved by NOT APPROVED Issue date April

More information

Imaging in gastric cancer

Imaging in gastric cancer Imaging in gastric cancer Gastric cancer remains a deadly disease because of late diagnosis. Adenocarcinoma represents 90% of malignant tumors. Diagnosis is based on endoscopic examination with biopsies.

More information

Surgeons Perspective: LN as a Draining Pattern. Jose A. Karam, MD, FACS Associate Professor Department of Urology

Surgeons Perspective: LN as a Draining Pattern. Jose A. Karam, MD, FACS Associate Professor Department of Urology Surgeons Perspective: LN as a Draining Pattern Jose A. Karam, MD, FACS Associate Professor Department of Urology Disclosures EMD Serono, Pfizer, Novartis: Advisory board/consultant Disclosures I perform

More information

Imaging Guided Biopsy. Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer

Imaging Guided Biopsy. Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer Imaging Guided Biopsy Edited & Presented by ; Hussien A.B ALI DINAR. Msc Lecturer,Reporting Sonographer Objective By the End of this lessons you should : Define what biopsy Justify Aim to perform biopsy

More information

Bronchogenic Carcinoma

Bronchogenic Carcinoma A 55-year-old construction worker has smoked 2 packs of ciggarettes daily for the past 25 years. He notes swelling in his upper extremity & face, along with dilated veins in this region. What is the most

More information

Case Report Sarcomatoid Renal Cell Carcinoma Metastasis to the Penis

Case Report Sarcomatoid Renal Cell Carcinoma Metastasis to the Penis Case Reports in Urology Volume 2015, Article ID 467974, 4 pages http://dx.doi.org/10.1155/2015/467974 Case Report Sarcomatoid Renal Cell Carcinoma Metastasis to the Penis Victor D. Liou, 1 Oussama M. Darwish,

More information

Ovarian Tumors. Andrea Hayes-Jordan MD FACS, FAAP Section Chief, Pediatric Surgery/Surgical Onc. UT MD Anderson Cancer Center

Ovarian Tumors. Andrea Hayes-Jordan MD FACS, FAAP Section Chief, Pediatric Surgery/Surgical Onc. UT MD Anderson Cancer Center Ovarian Tumors Andrea Hayes-Jordan MD FACS, FAAP Section Chief, Pediatric Surgery/Surgical Onc. UT MD Anderson Cancer Center Case 13yo female with abdominal pain Ultrasound shows huge ovarian mass Surgeon

More information

Stage 3c breast cancer survival rate

Stage 3c breast cancer survival rate Stage 3c breast cancer survival rate There are five main subtypes of ovarian carcinoma, of which high-grade serous carcinoma is the most common. [3]. Testicular cancer is generally found in young men.

More information

Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services. Cancer of Unknown Primary Network Site Specific Group. Clinical Guidelines

Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services. Cancer of Unknown Primary Network Site Specific Group. Clinical Guidelines Somerset, Wiltshire, Avon and Gloucestershire (SWAG) Cancer Services Cancer of Unknown Primary Network Site Specific Group Revision due: April 2019 Page 1 of 11 VERSION CONTROL THIS IS A CONTROLLED DOCUMENT.

More information

SURGICAL ANATOMY OF RETROPERITONEUM AND LYMPHADENECTOMY

SURGICAL ANATOMY OF RETROPERITONEUM AND LYMPHADENECTOMY SURGICAL ANATOMY OF RETROPERITONEUM AND LYMPHADENECTOMY P. De Iaco S.Orsola-Malpighi Hospital - Bologna Unit Oncological Gynecology PELVIC AND AORTIC LYMPH NODE METASTASIS IN EPITHELIEL OVARIAN CANCER

More information

objectives Pitfalls and Pearls in PET/CT imaging Kevin Robinson, DO Assistant Professor Department of Radiology Michigan State University

objectives Pitfalls and Pearls in PET/CT imaging Kevin Robinson, DO Assistant Professor Department of Radiology Michigan State University objectives Pitfalls and Pearls in PET/CT imaging Kevin Robinson, DO Assistant Professor Department of Radiology Michigan State University To determine the regions of physiologic activity To understand

More information

Cancer of Unknown Primary (CUP) Protocol

Cancer of Unknown Primary (CUP) Protocol 1 Department of Oncology. Cancer of Unknown Primary (CUP) Protocol Version: Document type: Document sponsor Designation Document author [ s] Designation[s] Approving committee / Group Ratified by: Date

More information

Testicular Carcinomas and Carcinoma of the Prostate

Testicular Carcinomas and Carcinoma of the Prostate Testicular Carcinomas and Carcinoma of the Prostate PAUL F. SCHELLHAMMER, M.D. Associate Professor of Urology, Eastern Virginia Medical School, Norfolk, Virginia TESTICULAR CARCINOMAS Incidence Testicular

More information

Testicular Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version November 2, NCCN.org.

Testicular Cancer. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version November 2, NCCN.org. NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines ) Version 1.2017 November 2, 2016 NCCN.org Continue Panel Members * Timothy Gilligan, MD/Chair Case Comprehensive Cancer Center/ University

More information

MEASUREMENT OF EFFECT SOLID TUMOR EXAMPLES

MEASUREMENT OF EFFECT SOLID TUMOR EXAMPLES MEASUREMENT OF EFFECT SOLID TUMOR EXAMPLES Although response is not the primary endpoint of this trial, subjects with measurable disease will be assessed by standard criteria. For the purposes of this

More information

R the first site of metastasis for germinal DISTRIBUTION OF RETROPERITONEAL LYMPH GERMINAL TUMORS NODE METASTASES IN TESTICULAR

R the first site of metastasis for germinal DISTRIBUTION OF RETROPERITONEAL LYMPH GERMINAL TUMORS NODE METASTASES IN TESTICULAR DISTRIBUTION OF RETROPERITONEAL LYMPH NODE METASTASES IN TESTICULAR GERMINAL TUMORS RISWAMAY RAY, MD, STEVEN I. HAJDU, WILLET F. WHITMORE, JR, MD MD, AND A detailed analysis of the retroperitoneal lymph

More information

The Importance of One-Stage Median Stemotomy and Retroperitoneal Node Dissection in Disseminated Testicular Cancer

The Importance of One-Stage Median Stemotomy and Retroperitoneal Node Dissection in Disseminated Testicular Cancer The Importance of One-Stage Median Stemotomy and Retroperitoneal Node Dissection in Disseminated Testicular Cancer Isidore Mandelbaum, M.D., Peter B. Yaw, M.D., Lawrence H. Einhorn, M.D., Stephen D. Williams,

More information