Ultrasound morphological patterns of testicular tumours, correlation with histopathology

Introduction: Ultrasound (US) plays a key role in the detection of testicular tumours. However, reliable characterisation of testicular tumours with US is difficult. The purpose of this study was to investigate the morphological patterns of testicular tumours as seen on modern US imaging and correlate these with histology. Methods: The imaging features of 50 testicular tumours were analysed and compared with histology. The US appearance was categorized into 15 distinct morphological patterns. Results: Patient's age ranged from 0.5 to 85 years. Of the 50 tumours in our series, 49 were malignant. Nearly half of the malignancies were seminomatous germ cell tumours (SGCTs). Tumours ranged in size from 10 to 130 mm with considerable overlap of size between tumours of different histological type. Even small (10 mm) tumours in our cohort were malignant. SGCTs demonstrated a narrower range of morphological appearances than non-seminomatous germ cell tumours (NSGCTs). Calcification was common in both SGCT and NSGCTs. Multicomponent cystic-solid appearance was only seen in NSGCTs. Conclusion: The differentiation of testicular tumours with US continues to be challenging. In this paper, we have demonstrated the diverse morphological patterns of testicular neoplasms and have proposed the study of tumour morphological features as a promising research direction.