Management of nonpalpable testicular tumors

Sheynkin, Yefim; Sukkarieh, Troy; Lipke, Michael C.; Cohen, Harris L.; Schulsinger, David A.

doi:10.1016/j.urology.2003.12.054

Cited by 43 publications

(26 citation statements)

References 15 publications

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“…Organ sparing surgery has also been advocated by many authors as a way to preserve testicular function, particularly in patients with monorchism or infertility. 1,2,6,16,17 Hopps and Goldstein observed that the majority of nonpalpable lesions are benign and, therefore, advocated a testis sparing approach with microsurgical excision and frozen section examination of excised lesions. 16 If the tumor is malignant, radical orchiectomy is performed.…”

Section: Discussionmentioning

confidence: 99%

Incidental Testicular Lesions Found During Infertility Evaluation are Usually Benign and May be Managed Conservatively

2008

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Section: Discussionmentioning

confidence: 99%

Incidental Testicular Lesions Found During Infertility Evaluation are Usually Benign and May be Managed Conservatively

2008

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“…The mean tumour diameter of malignant lesions in that study was comparable to our series. A more recent study by Sheynkin et al [15] confirmed these results, with only 2 of 8 non-palpable testicular masses proving to be malignant following radical orchidectomy. Another study by Leroy et al [16] provided further support for the low rate of malignant pathology in small, non-palpable testicular masses by demonstrating a 27% rate of malignancy in lesions with a mean diameter of 7.5 mm.…”

Section: Discussionmentioning

confidence: 78%

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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“…Similarly, Sheynkin et al (10) reported a 75% prevalence of benign lesions among eight non-palpable testicular masses. It is noteworthy that up to 100% of non-palpable testicular lesions are benign Leydig cell tumor.…”

Section: Discussionmentioning

confidence: 86%

Diagnostic ultrasound-guided excisional testicular biopsy for small (< 1 cm) incidental nodules. A single institution experience

Fabiani

Filosa

Fioretti

et al. 2014

Arch Ital Urol Androl

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Introduction and objectives:The widespread use of scrotal ultrasound (SUS) has led to a marked increase in the number of incidentally detected testicular lesions. A small incidental nodule (STN) has defined as a non palpable (< 10 mm), asymptomatic solid lesion with normal levels of oncological testicular markers. Nowadays the lack of agreement on the topic causes managing problems to andrologists. We present our experience consisting in 8 cases of STN discovered by SUS performed for different clinical indications. Matherial and methods: We retrieved from our ultrasonographic files the clinical information about 717 patients evaluated for andrological problems. Patients with STN underwent to a complete clinical history and physical examination as well as oncological testicular markers measurement and ormonal assessment and then received a diagnostic ultrasound guided excisional biopsy (DEB). Surgical approach was performed through an inguinal incision. Using the coordinates previously obtained from preoperative SUS, STN was localized by intraoperative SUS. The lesion was enucleated and sent to the Pathology department for frozen section examination (FSE). Biopsies of affected testis (TB) were also performed. Post-excision ultrasound has been used to confirm the complete removal of the nodule. Whether pathological findings were benign, testis sparing surgery (TSS) was performed. Immediate radical orchidectomy (IRO) was performed if FSE and TB findings suggested a malignant lesion. Results: STNs were discovered in 8 patients (1,1%). Very small lesions (< 5 mm) were detected in 50% of cases. We performed four IRO and four DEB with consequent TSS. In one case we performed a delayed radical orchidectomy (DRO). At FSE pathologist reported 3 Leydig cell tumor and 3 seminoma and an inflammatory regressive lesion in one case. FSE on TB reported intratesticular neoplasia (TIN) in three cases. In one case nodule wasn't sent to FSE. We observed a concordance between FSE and definitive pathologic report in six cases (75%). SummaryNo conflict of interest declared.

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Management of nonpalpable testicular tumors

Cited by 43 publications

References 15 publications

Incidental Testicular Lesions Found During Infertility Evaluation are Usually Benign and May be Managed Conservatively

Incidental Testicular Lesions Found During Infertility Evaluation are Usually Benign and May be Managed Conservatively

Nonpalpable Testicular Masses—Should We Be Worried?

Diagnostic ultrasound-guided excisional testicular biopsy for small (< 1 cm) incidental nodules. A single institution experience

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