Grossing and reporting of testicular tumor specimens : An evidence-based approach

Ambekar, Asawari; Rao, Vishal; Pai, Sanjay A; Bindhu,; Midha, Divya; Kaushal, Seema; Patil, Sachin; Jagdale, Rakhi V; Soni, Shailesh; Kulkarni, Bijal; Sundaram, Sandhya; Kumar, Rajesh; Desai, Sangeeta; Menon, Santosh

doi:10.4103/ijc.ijc_1072_19

Cited by 3 publications

(2 citation statements)

References 13 publications

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“…Due to the existence of primary lesions and systemic manifestations, secondary tumors are Relatively easy to diagnose. Although there are many pathological types of testicular tumors, most of them are germ cell tumors ( 2 , 3 ). Ultrasound, the first-choice imaging examination for scrotal disease ( 3 , 4 ), is easy to detect masses, but qualitative diagnosis is more difficult.…”

Section: Introductionmentioning

confidence: 99%

“…However, if lymphoma is diagnosed preoperatively by ultrasound, a puncture biopsy can be taken to make a definitive diagnosis, thus saving time for surgery. However, seminoma is uncommon in elderly patients ( 2 ), so it cannot follow the general ideas and norms for diagnosing and treating testicular tumors, and its characteristics need to be considered separately. This study retrospectively analyzed the conventional ultrasonography and contrast-enhanced ultrasonography of primary testicular tumors in patients over 50 years old, in order to make an accurate preoperative diagnosis and guide clinical treatment.…”

Section: Introductionmentioning

confidence: 99%

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The value of contrast-enhanced ultrasonography in differential diagnosis of primary testicular germ cell tumors and non-germ cell tumors over 50 years old

et al. 2023

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BackgroundUnlike young and middle-aged patients, seminoma is not common in patients with primary testicular tumors over the age of 50, so it cannot follow the general ideas and norms for diagnosing and treating testicular tumors, and its characteristics need to be considered separately.MethodsThe conventional ultrasonography and contrast-enhanced ultrasonography (CEUS) findings of primary testicular tumors in patients over 50 years old were retrospectively analyzed and compared with the pathological results to compare the diagnostic value of these two methods.ResultsOf the 13 primary testicular tumors, 8 were primary lymphomas. Conventional ultrasound of 13 cases of testicular tumors showed hypoechoic with rich blood flow, and it was difficult to identify the type accurately. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of conventional ultrasonography in diagnosing non-germ cell tumors (lymphoma and Leydig cell tumor) were 40.0%, 33.3%, 66.7%, 14.3%, and 38.5%, respectively. CEUS findings: 7 of 8 lymphomas showed uniform hyperenhancement. 2 cases of Leydig cell tumors showed uniform high enhancement. 2 cases of seminoma and 1 case of spermatocytic tumor showed heterogeneous enhancement, with necrosis in the interior. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate of non-germ cell tumor diagnosis according to the non-necrotic area of CEUS were 90.0%, 100.0%, 100.0%, 75.0% and 92.3%, respectively. Compared with conventional ultrasound, the difference was statistically significant (P=0.039).ConclusionsPrimary testicular tumors in patients over 50 years old are mainly lymphoma, and CEUS is significantly different between germ cell tumors and non-germ cell tumors. Compared with conventional ultrasound, CEUS can distinguish testicular germ cell tumors from non-germ cell tumors more accurately. Preoperative ultrasonography is significant for accurate diagnosis and can guide clinical treatment.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The value of contrast-enhanced ultrasonography in differential diagnosis of primary testicular germ cell tumors and non-germ cell tumors over 50 years old

et al. 2023

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The value of contrast-enhanced ultrasonography in the diagnosis of primary testicular non-neoplastic and neoplastic lesions in adults

2022

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Background Different pathological types of testicular tumors are treated differently. Malignant germ cell tumors require radical orchiectomy, while benign tumors may only need mass enucleation. Contrast-enhanced ultrasonography (CEUS) is more sensitive than conventional ultrasonography in displaying tumor microvessels, which helps distinguish between benign and malignant tumors. Methods This was a retrospective analysis of 35 patients with pathological-confirmed primary testicular non-neoplastic and neoplastic lesions in our hospital from February 2017 to February 2022. Conventional ultrasonography and CEUS imaging findings of included lesions were retrospectively analyzed and their diagnostic values were compared with the pathological results. Results There were 13 cases of benign testicular lesions (including 1 case of spontaneous hematoma, 2 cases of segmental infarctions, 5 cases of epidermoid cysts, 2 cases of Sertoli cell tumors, and 3 cases of Leydig cell tumors) and 23 cases of malignant testicular lesions (including 10 cases of seminomas, 1 case of embryonal carcinoma, 2 cases of mixed germ cell tumors, 2 cases of spermatocytic tumors, and 8 cases of lymphomas). The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates of conventional ultrasound in diagnosing benign testicular tumors by "onion skin-like" echo (epidermoid cysts) and peripheral annular blood flow were 30.8%, 100.0%, 100.0%, 71.9% and 75.0%, respectively. All testicular non-neoplastic lesions and epidermoid cysts showed no enhancement by CEUS. All Sertoli-Leydig cell tumors (SLCTs)’ CEUS imaging showed uniform high enhancement (no necrosis area), fast forward, and slow backward. 80.0% (12/15) malignant germ cell tumors showed heterogeneous enhancement and fast forward and fast backward in CEUS. All lymphomas showed fast forward and fast backward, and 87.5% (7/8) of them showed uniform high levels of enhancement in CEUS. According to CEUS without enhancement (non-neoplastic lesions and epidermoid cysts) and uniform high enhancement with fast forward and slow backward (SLCT), the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates for diagnosing benign testicular tumors were all 100.0%. Compared with conventional ultrasound, the difference was statistically significant (p = 0.004). Conclusions CEUS could accurately distinguish between benign and malignant testicular tumors, as well as differentiate specific pathological types (testicular focal infarction, epidermoid cysts, spermatocytic tumors, SLTC and lymphoma). Accurate preoperative diagnosis is critical for guiding the selection of appropriate treatment plans for different pathological types of testicular tumors.

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The value of contrast-enhanced ultrasonography in the diagnosis of primary testicular non-neoplastic and neoplastic lesions in adults

Xue

Zhang

Wang

2022

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Background: Different pathological types of testicular tumors are treated differently. For example, malignant germ cell tumors require radical orchiectomy, benign tumors only require mass enucleation and segmental infarction does not require treatment. Contrast-enhanced ultrasonography (CEUS) can more sensitively display tumor microvessels, thereby distinguishing between benign and malignant tumors.Methods: This was a retrospective analysis of 35 patients with primary testicular non-neoplastic and neoplastic confirmed by pathology in our hospital from February 2017 to February 2022. Conventional ultrasonography and CEUS of primary testicular non-neoplastic lesions and neoplastic lesions of different pathological types in adults were retrospectively analyzed and their diagnostic values were compared with the pathological results. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates for conventional ultrasound in the diagnosis of benign testicular tumors based on "onion skin-like" echo (epidermoid cysts) and peripheral annular blood flow were 30.8%, 100.0%, 100.0%, 71.9% and 75.0%, respectively. According to CEUS without enhancement (non-neoplastic lesions and epidermoid cysts) and uniform high enhancement with fast forward and slow backward (SLCT), the sensitivity, specificity, positive predictive value, negative predictive value and accuracy rates for diagnosing benign testicular tumors were 100.0%, 100.0%, 100.0%, 100.0% and 100.0%, respectively. Compared with conventional ultrasound, the difference was statistically significant (P=0.004).Conclusions: CEUS could accurately distinguish between benign and malignant testicular tumors and also diagnosed specific pathological types (such as testicular focal infarction, epidermoid cysts, spermatocytic tumors, SLTC and lymphoma). Different pathological types of testicular tumors had different treatment options; thus, accurate preoperative diagnosis was of great significance and could guide the selection of appropriate treatment options.

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Grossing and reporting of testicular tumor specimens : An evidence-based approach

Cited by 3 publications

References 13 publications

The value of contrast-enhanced ultrasonography in differential diagnosis of primary testicular germ cell tumors and non-germ cell tumors over 50 years old

The value of contrast-enhanced ultrasonography in differential diagnosis of primary testicular germ cell tumors and non-germ cell tumors over 50 years old

The value of contrast-enhanced ultrasonography in the diagnosis of primary testicular non-neoplastic and neoplastic lesions in adults

The value of contrast-enhanced ultrasonography in the diagnosis of primary testicular non-neoplastic and neoplastic lesions in adults

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