Testicular masses

Germ Cell Tumors (95%)

• Seminomas (45%)
• NonSeminomas (50%)
  • Mixed GCT (40%) – elevated AFP
  • Teratomas (30%) – AFP and HCG neg
  • Embryonal Cell Tumor (20%)
  • Choriocarcinoma (1%) – most lethal, elevated HCG
  • Yolk Sac – elevated AFP

Non Germinal Tumors (5%)

• Leydig Cell Tumors – 30% secrete estrogen (AFIP notes)
• Sertoli Cell Tumors – can also secrete estrogen

Epidermoid cyst

• Target or bull's eye appearance of an avascular testicular mass
• Sharply circumscribed encapsulated round
• Onion-skin appearance due to alternating hypo- and hyperechoic rings
• Surgical enucleation, testicular sparing
• Benign

Extratesticular Masses

Adenomatoid Tumor

• Rare, but most common extratesticular neoplasm
• Benign