Computed tomographic appearances of treated metastatic testicular tumours

Recent therapeutic advances have considerably improved survival rates in patients with testicular tumours. Computed tomography (CT) permits accurate staging and follow-up monitoring of these patients, and it is important, therefore, to be familiar with the evolution of abnormalities on CT after treatment. This study was undertaken to evaluate these appearances and consider their impact on management. Eighty-three patients with metastatic testicular neoplasms had serial CT scans as part of their management. The average age was 34 years (range 19-66 years) with a mean follow-up period of 30 months (range 3-97 months). Seventy-three patients had nodal disease at some stage: 44% reverted to normal on treatment, with no recurrence, while 30% regressed but did not clear completely. Thirty-six patients had lung lesions: although most responded to treatment persistent abnormality was observed in 39% of cases. Nine patients had extranodal disease. A variable response to treatment is reflected by CT findings that contribute to the development of a follow-up strategy whereby successful therapy may be recognised and residual or recurrent disease confirmed.