Microsurgical Testis-sparing Surgery in Small Testicular Masses: Seven Years Retrospective Management and Results

Stefani, Stefani De; Isgrò, Gianmarco; Varca, Virginia; Pecchi, Annarita; Bianchi, Giampaolo; Carmignani, G.; Derchi, Lorenzo E.; Micali, Salvatore; Macciò, Livia; Simonato, Alchiede

doi:10.1016/j.urology.2011.12.039

Cited by 50 publications

(46 citation statements)

References 22 publications

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“…He reported on four patients treated using this approach, concluding that this type of surgery provided the opportunity to remove benign masses as well as malignant lesions, with appropriate margins, in selected cases. Other investigators have also proposed US-guided needle localization with the subsequent performance of testicle-sparing surgery [12]. For most (40.1 %) of the patients in our study, the diagnosis was incidental and the testicular mass was completely asymptomatic.…”

Section: Discussionmentioning

confidence: 61%

Efficacy of ultrasound-guided testicle-sparing surgery for small testicular masses

Dell’Atti¹

2015

J Ultrasound

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Purpose The aim of the present study was to evaluate evolution of conservative echo-guided surgery for testicular tumours B1.5 cm and to assess the safety of this surgical procedure. Methods 49 consecutive patients diagnosed with ultrasonography testicular lesions (mono or bilateral) B1.5 cm and treated with conservative echo-guided testicular surgery were examined. The parameters considered in this retrospective analysis included case history, physical examination, scrotal and abdominal ultrasonography, computed tomography scan, size of the nodule (maximum diameter), tumour markers, chest radiography, frozen section examination, histologic size of the tumour, overall survival (OS) and findings on follow-up. Results Mean age of patients was 33 years (range 18-62). Patients who presented with a palpable testicular nodule were 32.7 %, gynecomastia 10.2 %, precocious pseudopuberty 4 %, and scrotal pain 12.2 %. Permanent section examination confirmed the FSE data in all cases of certainty malignant lesion and definitive histological types were: 22 seminoma, 13 non-seminomatous or mixed germ cell tumours, 4 Leydig tumours, 2 hamartoma, 1 epidermoid cyst, 2 sertoli cell tumours, and 5 fibrous pseudotumour. No complications intra-and postoperative were observed. Overall survival was 100 % and scrotal US showed evidence of local tumour recurrence in 6 patients (12.2 %) after a mean follow-up of 34.7 months. ConclusionThe OS, the low rate of local recurrence, and absence of complications, tend to demonstrate the safety of the procedure. The benefits to testicular-sparing surgery include improving the patient's overall quality of life, fertility, endocrine function and negative cosmetic effects of radical orchiectomy.Keywords Testicular tumour Á Ultrasound Á Testiclesparing surgery Á Small testicular mass Á Non-palpable Riassunto Scopo del lavoro Lo scopo del presente studio è stato quello di valutare il ruolo della terapia chirurgia ecoguidata conservativa nel trattamento dei tumori testicolari B1.5 cm e valutarne la sicurezza ed efficacia. Metodi Furono esaminati 49 pazienti con diagnosi ecografica di lesione testicolare (mono o bilaterale) B1.5 cm e sottoposti a chirurgia testicolare conservativa ecoguidata. I parametri presi in considerazione in questo studio retrospettivo furono la storia clinica del paziente, l'esame obiettivo, l'ecografia scrotale ed addominale, la TAC, le dimensioni della lesione, i marcatori tumorali, la radiografia del torace, l'esame istologico estemporaneo e definitivo della lesione, il tasso di sopravvivenza globale e i risultati del follow-up. Risultati L'età media dei pazienti è stata di 33 anni (range 18-62). Il 32.7 % dei pazienti presentavano un nodulo testicolare apprezzabile palpatoriamente, il 10.2 % ginecomastia, il 4 % pseudopubertà precoce, mentre il 12.2 % dolore scrotale. In tutti i casi l'esame istologico definitivo delle lesioni tumorali aveva confermato i risultati riscontrati all'esame istologico estemporaneo. Gli istotipi definitivi furono: 22 tumori seminomatosi, 13...

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Section: Discussionmentioning

confidence: 61%

Efficacy of ultrasound-guided testicle-sparing surgery for small testicular masses

Dell’Atti¹

2015

J Ultrasound

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“…The final pathological examination demonstrated typical seminomas in both cases. 21 These two patients underwent RO. After a mean follow-up of 35 ± 25 months, all patients were found to be free from disease.…”

Section: Histological Patterns and Oncological Outcomes Of The Reportmentioning

confidence: 99%

“…The mass is usually identified by straight palpation of the testis or with intra-operative ultrasonography (US), usually guided by a needle. 18,21 The use of cold ischaemia is still controversial, and some authors consider this approach even harmful. 32 After the complete enucleation of the testicular mass, with or without a rim of a normal-appearing parenchyma, frozen section examination (FSE) is generally performed.…”

Section: Indications For Testis-sparing Surgery Operative Technique mentioning

confidence: 99%

Role of testis-sparing surgery in the conservative management of small testicular masses: Oncological and functional perspectives

Borghesi

Brunocilla

Schiavina

et al. 2015

Actas Urológicas Españolas (English Edition)

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“…However, in this regard, there is a difference between patients undergoing enucleation of a benign versus a malignant lesions. In larger series of patients with benign lesions, no hypogonadism requiring testosterone replacement was observed [6,15]. In the largest series of organ-sparing tumor resection, Heidenreich et al [4] showed physiological testosterone levels in 85% of the patients; in 15%, secondary hypogonadism developed.…”

Section: Figmentioning

confidence: 99%

Testis-Sparing Surgery in Patients with Germ Cell Cancer: Indications and Clinical Outcome

Pfister¹,

Paffenholz²,

Haidl³

2018

Oncol Res Treat

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Testicular cancer affects mainly young men between 20 and 30 years of age. Due to the availability of effective chemotherapy, the majority of patients are cured. Despite an increased risk of metachronous testicular cancer, it should be carefully considered whether immediate orchiectomy is indicated. This mini review gives an account of the available literature on testis-sparing surgery in patients with unilateral or bilateral synchronous or metachronous testicular cancer.

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Microsurgical Testis-sparing Surgery in Small Testicular Masses: Seven Years Retrospective Management and Results

Cited by 50 publications

References 22 publications

Efficacy of ultrasound-guided testicle-sparing surgery for small testicular masses

Efficacy of ultrasound-guided testicle-sparing surgery for small testicular masses

Role of testis-sparing surgery in the conservative management of small testicular masses: Oncological and functional perspectives

Testis-Sparing Surgery in Patients with Germ Cell Cancer: Indications and Clinical Outcome

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