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- Imaging
- • Ultrasound is extremely accurate, and any solid mass found on ultrasound should be considered cancerous
- until proven otherwise.
- • Chest x-rays to evaluate lung metastases. Many oncologists advise obtaining a baseline CT of the chest, even
- with a normal chest x-ray, to aid in follow-up.
- • CT scans of the abdomen and pelvis are part of the staging procedure to evaluate the abdominal
- (retroperitoneal) and pelvic lymph nodes . Some physicians now use MRI instead of CT scans.
- • Lymphangiography may help in about 10 percent of cases, but it is no longer routinely used because CT
- scans are more accurate. Sometimes it is still used to plan radiation therapy fields.
- • X-ray tomograms of the chest have been largely replaced by the more accurate chest CT scan.
- • Radionuclide bone and brain CT scans have to be done only when there are symptoms, although some
- doctors routinely order these scans for men with pure choriocarcinoma .
-
- Biopsy
- • The removal of the testicle (orchiectomy) through an incision in the groin—never a scrotal incision or an
- aspiration biopsy—is required for diagnosis. Even when metastatic disease is found, the testis where the
- cancer started still has to be removed because the primary tumor does not always respond fully to
- chemotherapy .
