Pelvic lymph nodes and pathways of disease spread in male pelvic malignancies.

Accurate nodal staging for male urogenital malignancies has important implications for therapy and prognosis. Male pelvic malignancies, including prostatic, penile, testicular, and bladder cancer, typically metastasize to regional lymph nodes first which is reported by the N-stage. Spread beyond these groups to non-regional nodes is regarded as M-stage disease.

In this review, we discuss the typical patterns of male pelvic lymphatic drainage and the tumor-specific regional nodal chains.

The impact of tumor-specific imaging features and the implications of previous treatments on staging are discussed.

While anatomic imaging, including CT and MRI, is the most widely employed imaging modality at present, newer functional imaging techniques have demonstrated promise in the accurate identification and characterization of nodal metastases.

Abdominal radiology (New York). 2019 Oct 31 [Epub ahead of print]

Aileen O'Shea, Aoife Kilcoyne, Sandeep S Hedgire, Mukesh G Harisinghani

Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA. ., Division of Abdominal Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA., Division of Cardiovascular Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA.