{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T18:23:28Z","timestamp":1787509408257,"version":"build-2736575974"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T00:00:00Z","timestamp":1676851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unlike young and middle-aged patients, seminoma is not common in patients with primary testicular tumors over the age of 50, so it cannot follow the general ideas and norms for diagnosing and treating testicular tumors, and its characteristics need to be considered separately.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The conventional ultrasonography and contrast-enhanced ultrasonography (CEUS) findings of primary testicular tumors in patients over 50 years old were retrospectively analyzed and compared with the pathological results to compare the diagnostic value of these two methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 13 primary testicular tumors, 8 were primary lymphomas. Conventional ultrasound of 13 cases of testicular tumors showed hypoechoic with rich blood flow, and it was difficult to identify the type accurately. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of conventional ultrasonography in diagnosing non-germ cell tumors (lymphoma and Leydig cell tumor) were 40.0%, 33.3%, 66.7%, 14.3%, and 38.5%, respectively. CEUS findings: 7 of 8 lymphomas showed uniform hyperenhancement. 2 cases of Leydig cell tumors showed uniform high enhancement. 2 cases of seminoma and 1 case of spermatocytic tumor showed heterogeneous enhancement, with necrosis in the interior. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of non-germ cell tumor diagnosis according to the non-necrotic area of CEUS were 90.0%, 100.0%, 100.0%, 75.0% and 92.3%, respectively. Compared with conventional ultrasound, the difference was statistically significant (P=0.039).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Primary testicular tumors in patients over 50 years old are mainly lymphoma, and CEUS is significantly different between germ cell tumors and non-germ cell tumors. Compared with conventional ultrasound, CEUS can distinguish testicular germ cell tumors from non-germ cell tumors more accurately. Preoperative ultrasonography is significant for accurate diagnosis and can guide clinical treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2023.1090823","type":"journal-article","created":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T01:59:55Z","timestamp":1676858395000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":12,"title":["The value of contrast-enhanced ultrasonography in differential diagnosis of primary testicular germ cell tumors and non-germ cell tumors over 50 years old"],"prefix":"10.3389","volume":"13","author":[{"given":"Nianyu","family":"Xue","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guoyao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengmin","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yijun","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,2,20]]},"reference":[{"key":"B1","first-page":"8","article-title":"EAU guidelines on testicular cancer","volume":"70","author":"Albers","year":"2016","journal-title":"Eur Urol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"7","DOI":"10.4103\/ijc.IJC_1072_19","article-title":"Grossing and reporting of testicular tumor specimens : An evidence-based approach","volume":"57","author":"Ambekar","year":"2020","journal-title":"Indian J Cancer"},{"key":"B3","doi-asserted-by":"publisher","first-page":"35","DOI":"10.2147\/RRU.S242398","article-title":"Review of testicular tumor: Diagnostic approach and management outcome in Africa","volume":"12","author":"Cassell","year":"2020","journal-title":"Res Rep Urol"},{"key":"B4","article-title":"Testicular cancer: Diagnosis and treatment","volume":"97","author":"Baird","year":"2018","journal-title":"Am Fam Physician"},{"key":"B5","doi-asserted-by":"publisher","first-page":"10","DOI":"10.1097\/JU.0000000000000318","article-title":"Diagnosis and treatment of early stage testicular cancer: AUA guideline","volume":"20","author":"Stephenson","year":"2019","journal-title":"J Urol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2016.4.320","article-title":"Testicular sparing surgery in small testis masses: A multinstitutional experience","volume":"88","author":"Galosi","year":"2016","journal-title":"Arch Ital Urol Androl"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2014.4.397","article-title":"Diagnostic-therapeutic pathway for small lesions of the testis","volume":"86","author":"Sbrollini","year":"2014","journal-title":"Arch Ital Urol Androl"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3892\/ol.2019.9953","article-title":"Primary testicular lymphoma: A SEER analysis of 1,169 cases","volume":"17","author":"Xu","year":"2019","journal-title":"Oncol Lett"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000000705","article-title":"Risk factors and treatment outcomes of 1,375 patients with testicular leydig cell tumors: Analysis of published case series data","volume":"203","author":"Fankhauser","year":"2020","journal-title":"J Urol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.4081\/aiua.2021.1.120","article-title":"Unusual clinical scenarios in urology and andrology","volume":"93","author":"Dell'Atti","year":"2021","journal-title":"Arch Ital Urol Androl"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.29271\/jcpsp.2021.06.722","article-title":"Spermatocytic tumor of testis in a young Male","volume":"30","author":"Qureshi","year":"2021","journal-title":"J Coll Physicians Surg Pak"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.12998\/wjcc.v9.i35.11115","article-title":"Spermatocytic tumor: A rare case report","volume":"9","author":"Hao","year":"2021","journal-title":"World J Clin cases"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1090823\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,20]],"date-time":"2023-02-20T01:59:59Z","timestamp":1676858399000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1090823\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,20]]},"references-count":12,"alternative-id":["10.3389\/fonc.2023.1090823"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1090823","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,20]]},"article-number":"1090823"}}