Nonpalpable Intratesticular Masses Detected Sonographically

Comiter, Craig V.; Benson, Carol; Capelouto, Carl C.; Kantoff, Philip W.; Shulman, Lawrence N.; Richie, Jerome P.; Loughlin, Kevin R.

doi:10.1016/s0022-5347(01)66865-4

Cited by 75 publications

(24 citation statements)

References 13 publications

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“…Palpable lesions are likely to be malignant with a probability as high as 95% and standard treatment is radical orchiectomy. 10 The data in this report indicate that nonpalpable testicular lesions may be present in as many as a third of patients with severe male factor infertility. Management of nonpalpable lesions found on ultrasonography during infertility evaluation is less straightforward.…”

Section: Discussionmentioning

confidence: 61%

“…The earliest opportunity for detection and treatment of germ cell tumors is in men with nonpalpable hypoechoic lesions on ultrasound, leading some to suggest that aggressive treatment of nonpalpable lesions when no metastases are observed may prevent the need for additional therapy including chemotherapy. 10,15 Radical orchiectomy remains the standard approach for primary cancer control of germ cell tumors. Organ sparing surgery has also been advocated by many authors as a way to preserve testicular function, particularly in patients with monorchism or infertility.…”

Section: Discussionmentioning

confidence: 99%

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

2008

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 99%

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

2008

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“…Comiter et al [9] found a high rate of malignant pathology (73%) amongst non-palpable testicular masses, although this study included patients with retroperitoneal or neck masses in whom testicular ultrasound was performed in order to identify a potential primary tumour, and therefore this higher rate of malignancy would be expected. Hindley et al [18] reported 3 out of 4 non-palpable lesions to be seminomatous, whilst Avci et al [14] reported 8 out of 9 non-palpable masses to be malignant.…”

Section: Discussionmentioning

confidence: 94%

“…Although several case series have reported on the malignant risk of small, incidentally-detected testicular masses, results have been contradictory [5][6][7][8][9][10][11][12][13][14]. We report our experience in a contemporary series of patients who underwent radical orchidectomy for non-palpable testicular masses and comment on their malignant potential.…”

Section: Introductionmentioning

confidence: 92%

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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“…Ultrasound approaches 100% accuracy in identifying the intratesticular origin of scrotal swellings; 95% of intratesticular mass lesions are germ cell neoplasms. More common use of ultrasound has resulted in the finding of non-palpable intratesticular lesions and uncertainty about management [6]. Inguinal exploration for excision and frozen section analysis has been offered as an alternative to automatic inguinal orchiectomy for these patients; intraoperative ultrasound has been used as a surgical adjunct [7,8,9].…”

Section: Discussionmentioning

confidence: 99%

Testicular Tumor Ultrasound Characteristics and Association with Histopathology

et al. 2012

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Introduction: This study was undertaken to develop knowledge of ultrasound characteristics of germ cell testicular neoplasms, associate these characteristics with histopathologic tumor types, and lay a foundation for study of ultrasound findings in benign versus malignant testicular lesions. Materials and Methods: The medical records and ultrasound images of 107 patients with testicular tumor were reviewed. Demographic and clinical characteristics and ultrasound findings of patients with seminoma were compared to those of patients with non-seminoma. Results: 55 patients had seminoma (1 bilateral) and 52 non-seminoma. Ultrasound images of seminoma were more often hypoechoic, homogeneous, and lobulated than those of non-seminoma (p < 0.001). Images of non-seminoma were more often heterogeneous and cystic (p < 0.001). There was no difference in tumor size, multiplicity, presence of calcium or lesion margination. Testicular microlithiasis was more common in seminoma (p < 0.02). Conclusion: Careful analysis of ultrasound images can permit an educated assessment of testicular tumor histopathology.

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Nonpalpable Intratesticular Masses Detected Sonographically

Cited by 75 publications

References 13 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?

Testicular Tumor Ultrasound Characteristics and Association with Histopathology

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