Seminoma differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Differentiating Seminoma from other Diseases

• The most common presentation of testicular seminoma is a painless testicular mass. The main differential for testicular mass in young adults is non-seminomatous germ cell tumor (NGCT) which usually appear more heterogenous, often with cysts and calcification. Lymphadenopathy of non-seminomatous germ cell tumor may enhance more heterogenously.
• Testicular lymphoma is the main differential diagnosis to consider when para-aortic lymphadenopathy is the presenting finding or in the setting of bilateral testicular lesions.
• Testicular seminoma must be differentiated from:

Differential diagnosis of testicular seminoma

Unilateral testicular mass

Bilateral testicular mass

Neoplastic

Non neoplastic

Neoplastic

Non neoplastic

Non seminomatous germ cell tumor ❑ Testicular teratoma ❑ Testicular epidermoid ❑ Choriocarcinoma ❑ Embryonal cell carcinoma ❑ Yolk sac tumor ❑ Mixed germ cell tumor Sex cord/stromal tumors ❑ Leydig cell tumor ❑ Sertoli cell tumor Metastasis to testis

❑ Testicular cyst ❑ Tubular ectasia of rete testes ❑ Focal orchitis ❑ Focal intratesticular hemorrhage ❑ Testicular torsion ❑ Intra testicular adrenal rest ❑ Tuberculosis ❑ Sarcoidosis ❑ Polyorchidism ❑ Intratesticular varicocele ❑ Intratesticular arteriovenous malformation

❑ Acute lymphoblastic leukemia ❑ Chronic lymphocytic leukemia ❑ Non-Hodgkin's lymphoma ❑ Metastases

❑ Intra testicular adrenal rests