Accuracy of frozen section examination of testicular tumors

Tokuç, Reşit; Sakr, Wael; Pontes, J. Edson; Haas, Gabriel E.

doi:10.1016/0090-4295(92)90405-l

Cited by 73 publications

(29 citation statements)

References 19 publications

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“…In specialist units with the appropriate histological expertise this approach has been shown to have excellent results. FSA reported a correct diagnosis in all 26 cases described by Tokuic et al [21] and in the 317 malignant testicular tumours reported by Elert et al [22] FSA confirmed the correct diagnosis in all cases. However, this experience is not universal [13] and depends on the expertise of the pathologist and adequacy of the frozen section.…”

Section: Discussionsupporting

confidence: 59%

Nonpalpable Testicular Masses—Should We Be Worried?

Abboudi¹,

Malde²,

Mchaourab³

et al. 2013

OJU

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Objective: To report our experience of a contemporary series of patients who underwent radical orchidectomy for non-palpable testicular masses, in order to comment on their malignant potential and identify any factors predictive of a malignant outcome. Materials and Methods: We reviewed the case-notes of patients who underwent radical inguinal orchidectomy over a 22-month period between January 2010 and October 2011. Results: A total of 71 patients were analysed, with a mean (range) age of 45 years (17 -82). Overall, 41 (57.7%) orchidectomies were malignant and 30 (42.3%) were benign. There were 20 (28%) non-palpable testicular masses found incidentally on ultrasound, and of these 40% were malignant and 60% were benign. In total 6 of these non-palpable lesions were <1 cm in size, and of these 66.6% were malignant and 33.3% were benign. The majority of tumours were in patients under the age of 50, but there was no correlation between the lesion size and the risk of a malignant outcome. Conclusion: In view of the significant rate of malignancy in non-palpable testicular masses we recommend surgical intervention over surveillance alone. However, as the majority of these lesions may eventually turn out to be benign, we suggest that testis-sparing surgery is the optimal approach, and should be performed in centres where the required radiological, histopathological, and surgical expertise exists.

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Section: Discussionsupporting

confidence: 59%

Nonpalpable Testicular Masses—Should We Be Worried?

Abboudi¹,

Malde²,

Mchaourab³

et al. 2013

OJU

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“…When frozen section was performed, we found, as have others, that final pathology was in concordance with frozen section in all cases. 14,15 For our 3 cases that did not have a frozen section report, final pathology confirmed a benign lesion. In our experience cystic lesions of the testicle are always benign (benign simple cysts, epidermoid or dermoid cysts, or teratomas) and a frozen section analysis may be safely omitted when confronted with a predominantly cystic testicular tumor in a prepubertal child.…”

Section: Discussionmentioning

confidence: 53%

Experience With Testis Sparing Surgery for Testicular Teratoma

et al. 2004

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“…a smaller study of around 30 patients also demonstrated 100% accuracy of FSe for diagnosing malignancy. 33 we believe that equivocal results do occur, and that a figure of around 98% accuracy in the hands of an experienced uropathologist is probably more accurate. 21 The main concerns associated with FSe are misinterpretation of the mass (if initial sectioning includes a margin of normal parenchyma around a malignant tumor so that the positive margin only becomes apparent on further permanent sectioning), and failing to detect CIS in the surrounding presumed-normal parenchyma.…”

Section: Biopsymentioning

confidence: 89%

Organ-sparing approaches for testicular masses

2010

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Organ-sparing approaches are currently practiced in urology for many malignancies. Partial orchiectomy of germ cell tumors (GCT) provides potential benefits over radical surgery by reducing the need for androgen substitution, lessening psychological stress, and preserving fertility, with a durable cure rate. Furthermore, many testicular lesions detected clinically or by ultrasonography will be benign, in which case radical orchiectomy represents overtreatment. Partial orchiectomy for benign lesions allows preservation of endocrine and exocrine function, and reduced risk of local recurrence. However, selection criteria are not clear and one must always be suspicious that a GCT might exist. Carcinoma in situ that remains in the salvaged testicle is a challenge to treat. Radiation therapy is an option, although there is a high chance that patients will subsequently require hormonal replacement. Partial orchiectomy should be undertaken only in selected patients--men with bilateral testicular cancer or GCT in a solitary testis--if the size and location of the mass are amenable to surgery. Informed patient consent discussing radical orchiectomy as the gold standard is mandatory, and discussion of the risks associated with CIS and its treatment, as well as the need for androgen supplementation are paramount. Alternative strategies of organ preservation, such as radiotherapy, HIFU and chemotherapy, might be appropriate treatment options in the future. However, the safety and efficacy of these procedures needs to be demonstrated in comparison with partial orchiectomy in larger and prospective studies with longer follow-up.

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Accuracy of frozen section examination of testicular tumors

Cited by 73 publications

References 19 publications

Nonpalpable Testicular Masses—Should We Be Worried?

Nonpalpable Testicular Masses—Should We Be Worried?

Experience With Testis Sparing Surgery for Testicular Teratoma

Organ-sparing approaches for testicular masses

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