Germ Cell Neoplasia in situ (GCNIS) in Testis-Sparing Surgery (TSS) for Small Testicular Masses (STMs)

Pierconti, Francesco; Martini, Maurizio; Grande, Giuseppe; Larocca, Luigi Maria; Sacco, Emilio; Pugliese, Dario; Gulino, Gaetano; Bassi, Pier Francesco; Milardi, Domenico; Pontecorvi, Alfredo

doi:10.3389/fendo.2019.00512

Cited by 5 publications

(8 citation statements)

References 37 publications

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“…In that scenario, field biopsies in a systematic and random manner are also mandatory as in situ germ cell neoplasia may be present elsewhere, even a long distance from the initial tumor. This finding reflects the malignant spread of the tumor and warrants treatment with adjuvant radiotherapy (12,33).…”

Section: Significance Of Frozen Section Analysis Testis-sparing Surgery and Random Biopsiesmentioning

confidence: 85%

“…STMs can be found at any age, ranging from childhood to adolescence and up to middle aged men (10)(11)(12). Male infertility presenting as dyspermia or the more severe azoospermia, are amongst the most frequently reported indications for ultrasound examination which results in the diagnosis of an incidental STM (13)(14)(15)(16)(17)(18)(19).…”

Section: Clinical Implications At Time Of Discovery Of Incidental Massmentioning

confidence: 99%

“…Male infertility presenting as dyspermia or the more severe azoospermia, are amongst the most frequently reported indications for ultrasound examination which results in the diagnosis of an incidental STM (13)(14)(15)(16)(17)(18)(19). Unspecified testicular or epididymal pain, an acute inflammation in the genital area, scrotal swelling, a history of trauma, varicocele, abdominal pain, hydrocele, suspicion of nephrolithiasis, gynecomastia, and follow up of cryptorchidism are also reported as indications (8,11,12,(20)(21)(22)(23)(24)(25). Of note small masses might be discovered during the follow up of patients with previous treatment of GCT or other testicular tumors (26)(27)(28), and a prior history of cryptorchidism might unmask an undetected testicular mass during follow up (12,15,23,29).…”

Section: Clinical Implications At Time Of Discovery Of Incidental Massmentioning

confidence: 99%

“…Unspecified testicular or epididymal pain, an acute inflammation in the genital area, scrotal swelling, a history of trauma, varicocele, abdominal pain, hydrocele, suspicion of nephrolithiasis, gynecomastia, and follow up of cryptorchidism are also reported as indications (8,11,12,(20)(21)(22)(23)(24)(25). Of note small masses might be discovered during the follow up of patients with previous treatment of GCT or other testicular tumors (26)(27)(28), and a prior history of cryptorchidism might unmask an undetected testicular mass during follow up (12,15,23,29). In the same vein, extra attention should be given to patients with suspected retroperitoneal, extragonadal GCT as STMs might indicate a burned out primary testicular tumor (30).…”

Section: Clinical Implications At Time Of Discovery Of Incidental Massmentioning

confidence: 99%

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Incidental testicular masses and the role of organ-sparing approach

Narayan

Brown

Ivaz

et al. 2021

Arch Ital Urol Androl

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Objectives: The widespread use of ultrasonography for the investigation of common urological conditions, such as infertility or pain, has resulted in an increased incidence of incidental non-palpable testicular masses. The majority of these are expected to be benign therefore a conservative approach, either active monitoring or organsparing approach, is recommended. However, there are no clinical or radiological parameters which define the exact nature of such lesions and optimal patient selection criteria are lacking. In this comprehensive review we discuss the significance of incidental, small testicular masses (STMs) and the role of organ-sparing approach in the management of these lesions. Materials and methods: A non-systematic search was performed using PubMed to identify articles that covered the following topics; clinical implications at diagnosis, role of imaging in identifying the malignant capabilities of a lesion, role of surgery and the final pathology. Results: Incidental STMs are routinely identified following ultrasound examination of infertile men. STMs usually measure a few millimeters in size and the majority of these are benign. Therefore, strict follow up or an organ-sparing approach, with utilisation of frozen section analysis (FSA), is favored for STMs. FSA has a high correlation with final pathology and prevents unnecessary orchidectomies. Advances in imaging, namely ultrasound and magnetic resonance imaging may provide enhanced assessment of STMs and guidance intraoperatively. Conclusions: The optimal approach is not well defined and there is no specific clinical parameter that can predict the nature of STMs. The increasing incidence of small, benign testicular masses has resulted in the development of organ-sparing surgery to investigate and manage these lesions. Organ-sparing surgery has been shown to be practical and carries excellent oncological outcomes.

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Section: Significance Of Frozen Section Analysis Testis-sparing Surgery and Random Biopsiesmentioning

confidence: 85%

Section: Clinical Implications At Time Of Discovery Of Incidental Massmentioning

confidence: 99%

Section: Clinical Implications At Time Of Discovery Of Incidental Massmentioning

confidence: 99%

Section: Clinical Implications At Time Of Discovery Of Incidental Massmentioning

confidence: 99%

See 2 more Smart Citations

Incidental testicular masses and the role of organ-sparing approach

Narayan

Brown

Ivaz

et al. 2021

Arch Ital Urol Androl

View full text Add to dashboard Cite

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“…Fakat bu hastaların uzun dönem takip verileri belirtilmemiştir. [19] Ye ve ark. 16 hastaya TKC uygulamışlardır.…”

Section: Discussionunclassified

4 mm’lik testis tümörüne ultrason eşliğinde işaretleme ile organ koruyucu cerrahi

Taşkapu¹,

Sönmez²,

Ecer³

et al. 2020

Androl Bul

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Sub‐chronic cadmium and lead compound exposure induces reproductive toxicity and development of testicular germ cell neoplasia in situ in murine model: Attenuative effects of resveratrol

Mitra

Patra

Saha

et al. 2022

J Biochem & Molecular Tox

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Cadmium and lead are widespread, nonbiodegradable heavy metals of perpetual environmental concerns. The present study aimed to evaluate whether sub‐chronic exposure to cadmium chloride (CdCl2) and lead acetate [Pb(CH3COO)2] induces reproductive toxicity and development of testicular germ cell neoplasia in situ (GCNIS) in swiss albino mice. The effects of resveratrol to reverse the metal‐induced toxicity were also analyzed. The mice were randomly divided into four groups for metal treatments and two groups received two different doses of each metal, CdCl2 (0.25 and 0.5 mg/kg) and Pb(CH3COO)2 (3 and 6 mg/kg). The fourth group received oral doses of 20 mg/kg resveratrol in combination with 0.5 mg/kg CdCl2 or 6 mg/kg Pb(CH3COO)2 for 16 weeks. Toxic effects of both metals were estimated qualitatively and quantitatively by the alterations in sperm parameters, oxidative stress markers, testicular histology, and protein expressions of the treated mice. Pronounced perturbation of sperm parameters, cellular redox balance were observed with severe distortion of testicular histo‐architecture in metal exposed mice. Significant overexpression of Akt cascade and testicular GCNIS marker proteins were recorded in tissues treated with CdCl2. Notable improvements were observed in all the evaluated parameters of resveratrol cotreated mice groups. Taken together, the findings of this study showed that long‐term exposure to Cd and Pb compounds, induced acute reproductive toxicity and initiation of GCNIS development in mice. Conversely, resveratrol consumption abrogated metal‐induced perturbation of spermatogenesis, testicular morphology, and the upregulation of Akt cascade proteins along with GCNIS markers, which could have induced the development of testicular cancer.

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Germ Cell Neoplasia in situ (GCNIS) in Testis-Sparing Surgery (TSS) for Small Testicular Masses (STMs)

Cited by 5 publications

References 37 publications

Incidental testicular masses and the role of organ-sparing approach

Incidental testicular masses and the role of organ-sparing approach

4 mm’lik testis tümörüne ultrason eşliğinde işaretleme ile organ koruyucu cerrahi

Sub‐chronic cadmium and lead compound exposure induces reproductive toxicity and development of testicular germ cell neoplasia in situ in murine model: Attenuative effects of resveratrol

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