Evaluation of Testicular Nonseminomatous Germ Cell Tumor Using Contrast-Enhanced Ultrasound

Ultrasound is the first-line and established imaging modality for the diagnosis of testicular masses and neoplasms, with high sensitivity. Conventional ultrasound can very reliably detect presence of an intratesticular mass although it may not specifically characterize them as benign or malignant and neoplastic or nonneoplastic or classify the type or subtype of neoplasm in every case. Contrast-enhanced ultrasound (CEUS) is a technique in which injected intravenous microbubbles can supplement the characterization of focal testicular masses through observation of real-time perfusion of the testis and the target mass. Testicular masses have been documented to demonstrate unique enhancing patterns on CEUS. We report a unique case involving a young male presenting with a palpable testicular mass in which CEUS aided in the diagnosis of testicular germ cell tumor. The diagnosis was subsequently confirmed by histopathological examination after surgery. This case report highlights the utility of CEUS as a useful complementary adjunct in diagnosing and characterizing nonseminomatous germ cell tumors of the testes with a review of the literature.