A review of the role of lymphography in the management of testicular tumours. 1975

D J Wilkinson, and J S MacDonald

The pedal lymphographic findings in 260 patients with testicular tumours are reviewed: 117 patients had a seminoma, 105 had a teratoma and 38 combined tumours. 26 percent of seminomas were associated with a positive lymphogram, corresponding figures being 42 percent for teratomas and 53 percent for combined tumours. The role of the lymphogram is (1) to stage the case so that the extent and form of the treatment can be logically assessed, (2) to plan accurately radiotherapy treatment fields, (3) to observe the results of treatment on serial follow-up films, (4) to detect the recurrence of tumour using "re-fill" lymphography if necessary, (5) to show possible unsuspected metastases involving supraclavicular and mediastinal glands, and (6) to give a prognosis, since a negative lymphogram suggests an excellent chance of survival. Three main types of lymphographic appearances are recognized: nodal, mass replacement and "pseudo-lymphomatous". Nodal deposits are most common. Most positive findings are in the para-aortic chain on the same side as the tumour. Iliac involvement is much less common. Seminomas in this series showed a 96 percent crude three-year survival rate. For teratomas and combined tumours the three-year survival rates were 59 percent and 61 percent respectively, but deaths are uncommon in the lymphographically negative Stage I cases. Bone deposits are rare. Only two were found in this series. We do not perform testicular lymphography, but consider there is a useful role for inferior venacavography when there is poor filling of upper para-aortic nodes at lymphography. The importance of taking follow-up films after the initial examination is stressed.

UI MeSH Term Description Entries
D008207 Lymphatic Metastasis Transfer of a neoplasm from its primary site to lymph nodes or to distant parts of the body by way of the lymphatic system. Lymph Node Metastasis,Lymph Node Metastases,Lymphatic Metastases,Metastasis, Lymph Node
D008220 Lymphography Radiographic study of the lymphatic system following injection of dye or contrast medium. Lymphangiography,Lymphangiographies,Lymphographies
D008297 Male Males
D009364 Neoplasm Recurrence, Local The local recurrence of a neoplasm following treatment. It arises from microscopic cells of the original neoplasm that have escaped therapeutic intervention and later become clinically visible at the original site. Local Neoplasm Recurrence,Local Neoplasm Recurrences,Locoregional Neoplasm Recurrence,Neoplasm Recurrence, Locoregional,Neoplasm Recurrences, Local,Recurrence, Local Neoplasm,Recurrence, Locoregional Neoplasm,Recurrences, Local Neoplasm,Locoregional Neoplasm Recurrences,Neoplasm Recurrences, Locoregional,Recurrences, Locoregional Neoplasm
D011379 Prognosis A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations. Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D001859 Bone Neoplasms Tumors or cancer located in bone tissue or specific BONES. Bone Cancer,Cancer of Bone,Cancer of the Bone,Neoplasms, Bone,Bone Neoplasm,Neoplasm, Bone
D002369 Castration Surgical removal or artificial destruction of gonads. Gonadectomy,Castrations,Gonadectomies
D004407 Dysgerminoma A malignant ovarian neoplasm, thought to be derived from primordial germ cells of the sexually undifferentiated embryonic gonad. It is the counterpart of the classical seminoma of the testis, to which it is both grossly and histologically identical. Dysgerminomas comprise 16% of all germ cell tumors but are rare before the age of 10, although nearly 50% occur before the age of 20. They are generally considered of low-grade malignancy but may spread if the tumor extends through its capsule and involves lymph nodes or blood vessels. (Dorland, 27th ed; DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1646) Disgerminoma,Disgerminomas,Dysgerminomas
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013724 Teratoma A true neoplasm composed of a number of different types of tissue, none of which is native to the area in which it occurs. It is composed of tissues that are derived from three germinal layers, the endoderm, mesoderm, and ectoderm. They are classified histologically as mature (benign) or immature (malignant). (From DeVita Jr et al., Cancer: Principles & Practice of Oncology, 3d ed, p1642) Dysembryoma,Teratoid Tumor,Teratoma, Cystic,Teratoma, Mature,Teratoma, Benign,Teratoma, Immature,Teratoma, Malignant,Benign Teratoma,Benign Teratomas,Dysembryomas,Immature Teratoma,Immature Teratomas,Malignant Teratoma,Malignant Teratomas,Teratoid Tumors,Teratomas,Teratomas, Benign,Teratomas, Immature,Teratomas, Malignant,Tumor, Teratoid,Tumors, Teratoid

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