The value of testicular ultrasound in the prediction of the type and size of testicular tumors

Abstract

Objectives:Ultrasound (US) is often used for the work-up of testicular pathology. The findings may implicate on its management. However, there is only scant data on the correlation between US findings and testicular tumor type and size. Herein, we report on a multicenter study, analyzing these correlations.Methods:The study included patients who underwent orchiectomy between 2000 and 2010. Their charts were reviewed for US echogeneity, lesion size, pathological dimensions, histology, and the presence of calcifications, fibrosis, necrosis and/or intraepithelial neoplasia. The incidence of these parameters in benign versus malignant lesions and seminomatous germ cell tumors (SGCT) versus nonseminomatous germ cell tumors (NSGCT) was statistically compared.Results:Eighty five patients fulfilled the inclusion criteria, 71 malignant (43 SGCT, 28 NSGCT) and 14 benign. Sonographic lesions were at least 20% smaller than the pathologically determined dimensions in 21 (25%) patients. The ability of US in estimating the size of malignant tumors was 71%, compared to 100% of benign tumors (p=0.03), with no significant difference between SGCT and NSGCT. Necrosis was more frequent in malignant tumors (p=0.03); hypoechogeneity and fibrosis were more frequent in SGCT than in NSGCT (p=0.002 and 0.04 respectively).Conclusions:Testis US of malignant lesions underestimates the size in 25% of the cases, a fact that may impact on the decision of testicular sparing surgery. The ultrasonic lesions were eventually proven to be benign in 16% of the cases. Therefore it is advised to apply frozen sections in borderline cases. Hypoechogeneity is more frequent in SGCT than NSGCT.

The Diagnostic and Therapeutic Approach to a Child Having Simultaneous Renal and Testicular Mass

“…In author's opinion in view of up to 95 % subclinical patent PPV, routine ultrasonography of scrotum (screening for testicular metastasis) with abdominal ultrasound can be a cost effective screening measure which might reduce the child tumor related morbidity and mortality. If we found any sonographic finding of solid or mixed cystic lesion mass than surgical exploration of concern testis should be done through high inguinal approach [26]. The author invites prospective studies in the subject, for analysis of cost effectiveness and manpower and time utilization.…”

Lesión quística testicular en un lactante: consideraciones diagnósticas y terapéuticas

“…En recién nacidos, la lesión benigna más frecuente es el tumor juvenil de células de la granulosa (7,24). Los quistes simples son infrecuentes y pueden sospecharse, como en el presente caso, ante una masa testicular en un lactante con hallazgos clínicos que orienten a etiología benigna sumado a la presencia de una lesión quística, encapsulada, sin evidencia de ecos en su interior ni flujo a la exploración Doppler (14).…”

“…Las características ecográficas del quiste epidermoide testicular son variables según la cantidad de material queratinizado acumulado en su interior y guardan semejanza con otras lesiones quísticas simples o complejas (8,12,13). Existen hallazgos ultrasonográficos más frecuentes en tumores benignos que pueden orientar el diagnóstico (14).…”

RE: Ultrasonic Measurement of Testicular Tumors and the Correlation with Pathologic Specimen Sizes

“…We read with great interest the article “The value of testicular ultrasound in the prediction of the type and size of testicular tumors” by Shtricker et al ( 1 ). They aimed to assess the correlation between ultrasound (US) findings and testicular tumor type and size.…”

“…Shtricker et al have designed this study as a multicenter study ( 1 ). This design may increase the variabilities in the tumor measurement.…”