Following diagnosis of a solid testicular tumour, a CT scan of the abdomen and lungs tells the doctor whether there is any identifiable disease outside the testis. For seminomas, the abdominal nodes are far and away the commonest first site of metastatic disease and so a normal abdominal CT scan is very reassuring in this tumour type and allows the doctor to give the tumour a stage 1 category (i.e. confined to the testis).
The same is true for teratomas, and the same staging applies although teratomas do not so invariably use the lymphatic system to spread and occasionally the abdominal lymph nodes may be ‘skipped’ by metastasising tumour cells.
Abdominal lymph nodes up to 2cm across take the staging to stage 2A whereas tumour masses in this region on CT scan of 2-5 cm and above 5 cm get staged as 2B and 2C respectively. Chest nodal metastases give the patient a stage 3 and lung metastases give him a stage 4 categorisation.
Clearly, the higher the stage, the more serious is the cancer.
