The management of stage I nonseminomatous testicular germ cell tumors

Testicular germ cell tumors represent the most common malignancies in young males; 70% of patients with seminomas and 50% of those with nonseminomatous germ cell tumors ( NSGCT) have clinical stage I at diagnosis. Lymphovascular invasion, embryonal- cell carcinoma component, absence of yolk sac histology and MIB1 proliferation rate represent predictors of micrometastatic disease in stage I NSGCT. Therapeutic options following orchiectomy in patients with stage I NSGCT comprise nerve- sparing retroperitoneal lymph node dissection, surveillance or adjuvant cisplatin- based chemotherapy. All available treatment modalities produce excellent results, with a long- term survival of almost 100%. Consequently, therapy- induced toxicity is an important concern in the management of these patients. An individually tailored approach that takes into account the prognostic factor profile as well as the patient’s preferences and their ability to comply with each one of the modalities is the key to the management of stage I testicular cancer

Aberrant vascular anatomy associated with artifactual focal avidity in the liver on PSMA PET

68Ga–prostate-specific membrane antigen (PSMA) PET/CT is a valuable tool for staging and restaging of prostate cancer. Prostate-specific membrane antigen expression is not specific to prostate cancer, as it is expressed in normal tissues as well as in neoplastic and nonneoplastic processes. Awareness of the broad possibility of lesions with PSMA avidity is necessary to recognize normal variants and avoid potential pitfalls in image interpretation. We present a series of cases showing physiologic focal PSMA avidity in hepatic segment IVb. We correlate this uptake with aberrant hepatic vasculature. The awareness of this variant is important for accurate image interpretation to prevent additional invasive procedures, undue treatment escalation, and denial of curative treatment to patients.https://journals.lww.com/nuclearmed/pages/default.aspxhj2023Nuclear Medicin