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.

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We thank Ms. Susanne Loomis of the Radiology Education and Media Services Massachusetts General Hospital, Harvard Medical School, Boston, USA for her assistance in producing the featured illustrations. Aileen O’Shea would like to acknowledge the contribution of the MGH-MacErlaine Research Scholarship from the Faculty of Radiologists, RCSI, Ireland and Massachusetts General Hospital.

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O’Shea, A., Kilcoyne, A., Hedgire, S.S. et al. Pelvic lymph nodes and pathways of disease spread in male pelvic malignancies. Abdom Radiol (2019).

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  • Groin
  • Humans
  • Lymph nodes/diagnostic imaging
  • Lymph nodes/pathology
  • Lymphatic metastasis
  • Magnetic resonance imaging
  • Tomography
  • Urogenital neoplasms/diagnostic imaging
  • Testicular cancer
  • Penile cancer
  • Prostate cancer
  • Bladder cancer