What Is the Malignant Potential of Small (&lt;2 cm), Nonpalpable Testicular Incidentalomas in Adults? A Systematic Review

Bertolotto, Michele; Campo, Irene; Pavan, Nicola; Stella, Alex Buoite; Cantisani, Vito; Drudi, Francesco Maria; Cova, Maria Assunta; Derchi, Lorenzo E.

doi:10.1016/j.euf.2022.10.001

Cited by 8 publications

(8 citation statements)

References 92 publications

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“…Therefore, this type of surgery is advocated by contemporary guidelines in all benign testicular neoplasms, unless the mass is multifocal or larger than 2 cm [ 33 , 34 ]. In very small masses (< 5 mm), even surveillance without upfront surgery may be considered [ 35 ]. In view of the present knowledge about MGST, there is only little doubt about the benign nature of this neoplasm, and thus, a conservative surgical procedure is clearly justified.…”

Section: Discussionmentioning

confidence: 99%

Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature

Dieckmann,

Tharun,

Angerer

et al. 2024

J Med Case Reports

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Background Sex cord gonadal stromal tumors compose less than 10% of all testicular neoplasms and consist of a variety of histological subtypes. In 2016, the World Health Organization introduced a novel subtype, the myoid gonadal stromal tumor, that consists of spindle-shaped cells with immunohistologic features of muscle cells. Only few cases have been reported to date. Due to its rarity and owing to its only recent introduction, the current knowledge about myoid gonadal stromal tumor is limited, and particularly, appropriate clinical management is still ill-defined. Case presentation A 47-year-old man of Caucasian descent presented with nonspecific scrotal discomfort. A roundish and well demarcated hypoechoic mass of 8.5 mm in diameter was detected in the cranial region of the left testis. Serum tumor marker levels were within normal ranges. Testis-sparing surgery revealed a 9-mm whitish, hard mass with sharp surgical margin. Histologically, the neoplasm consisted of microfibrillar tissue with spindle-shaped cells harboring elongated nuclei. Immunohistochemical work-up disclosed expression of desmin, small muscle actin, and S100 protein giving evidence for the myogenic nature of the neoplastic cells. There was no indication of malignancy, neither histologically nor clinically. Follow-up of 1 year was uneventful. Conclusion A literature survey revealed 22 previous cases of myoid gonadal stromal tumor. The median age was 37 years, the median size of the neoplasm was 20 mm, and there was no side-preponderance. Myoid gonadal stromal tumor is not much different from other subtypes of gonadal stromal tumors nor from testicular gem cell tumors regarding age and laterality; however, tumor size is smaller in myoid gonadal stromal tumors than in germ cell tumors. Although rarely performed so far, testis-sparing surgery probably constitutes an appropriate treatment of this neoplasm. Myoid gonadal stromal tumor represents an emerging novel entity of benign testicular new growths that caregivers of patients with testicular tumors should be aware of.

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Section: Discussionmentioning

confidence: 99%

Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature

Dieckmann,

Tharun,

Angerer

et al. 2024

J Med Case Reports

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“…Another systematic review reported on 1348 lesions in adult asymptomatic men, both fertile and infertile, with single, incidentally identified small testicular lesions (<2 cm), negative tumor markers, and no specific risk factors for malignancy. The pooled data from 108 infertile cases (77.7%) and 31 fertile cases (22.3%) did not reveal a statistical difference in the frequency of benign and malignant lesions [ 113 ].…”

Section: How To Evaluate the Risk Of Tc In Male Infertile Patients?mentioning

confidence: 99%

“…There are several limitations to these two meta-analyses. First, they include studies with low-evidence quality, such as case reports and congress abstracts [ 113 ]. Second, the criteria for defining small lesions differ between the two meta-analyses.…”

Section: How To Evaluate the Risk Of Tc In Male Infertile Patients?mentioning

confidence: 99%

Male Infertility and the Risk of Developing Testicular Cancer: A Critical Contemporary Literature Review

et al. 2023

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Background and Objectives: The relationship between male infertility (MI) and testicular cancer (TC) is bilateral. On one hand, it is well-established that patients diagnosed with TC have a high risk of pre- and post-treatment infertility. On the other hand, the risk of developing TC in male infertile patients is not clearly defined. The objective of this review is to analyze the histopathological, etiological, and epidemiological associations between MI and the risk of developing testicular cancer. This review aims to provide further insights and offer a guide for assessing the risk factors for TC in infertile men. Materials and Methods: A comprehensive literature search was conducted to identify relevant studies discussing the relationship between MI and the risk of developing TC. Results: The incidence rates of germ cell neoplasia in situ (GCNIS) appear to be high in infertile men, particularly in those with low sperm counts. Most epidemiological studies have found a statistically significant risk of developing TC among infertile men compared to the general or fertile male populations. The concept of Testicular Dysgenesis Syndrome provides an explanatory model for the common etiology of MI, TC, cryptorchidism, and hypospadias. Clinical findings such as a history of cryptorchidism could increase the risk of developing TC in infertile men. Scrotal ultrasound evaluation for testis lesions and microlithiasis is important in infertile men. Sperm analysis parameters can be useful in assessing the risk of TC among infertile men. In the future, sperm and serum microRNAs (miRNAs) may be utilized for the non-invasive early diagnosis of TC and GCNIS in infertile men. Conclusions: MI is indeed a risk factor for developing testicular cancer, as demonstrated by various studies. All infertile men should undergo a risk assessment using clinical examination, ultrasound, and semen parameters to evaluate their risk of TC.

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“…Testicular tumors typically appear as hypo-echoic lesions of any size, with signals of color-coded duplex sonography in the corresponding lesion. Benign lesions are also hypo-echoic but with sharply demarcated margins on US [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…Magnetic resonance imaging (MRI) of the scrotum with gadolinium-based contrast medium application provides higher sensitivity and specificity than scrotal US in the diagnosis of testicular masses and should be considered in cases remaining inconclusive after US [4]. Blood sample analysis did not reveal any pathological findings.…”

Section: Introductionmentioning

confidence: 99%

Unilateral, Small, Benign, Late-Onset, Large-Cell Calcifying Sertoli Cell Tumor: A Case Report

Angerer¹,

Wülfing²,

Gübitz³

et al. 2023

Cureus

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Large-cell calcifying Sertoli cell tumor (LCCST) is a rare, testicular sex cord, gonadal stromal tumor that belongs to the histological subgroup of Sertoli cell tumors. LCCSTs may involve malignant potential. However, metastasis is a rare phenomenon. We describe a case of benign late-onset LCCST with testis-sparing surgery. Modern imaging techniques were useful for considering organ-sparing surgery. The ultrasound of a 37-year-old man disclosed a sharp demarcated and strong hyper-echoic lesion sized 1.5 cm, with broad dorsal acoustic shadowing. Testicular tumor markers, including lactate dehydrogenase (LDH), alpha-fetoprotein (AFP), and Beta-human chorionic gonadotropin (ß-HCG) did not reveal any pathological finding. Contrast-enhanced MRI of the pelvis showed a ring-shaped tumor with a strong contrast medium enhancement. Sections of the tumor showed a hard mass with a white calcified ring. A frozen section examination of the testicular tumor did not indicate malignancy. Histologic examination revealed a prominent and noticeable calcification of approximately 3 mm thickness. Tumor cells presented in the form of solid nests, tubules, and cords. Our present case differs from previously reported LCCST cases because the tumor was unilateral, smaller in size, and presented in an older patient.

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What Is the Malignant Potential of Small (<2 cm), Nonpalpable Testicular Incidentalomas in Adults? A Systematic Review

Cited by 8 publications

References 92 publications

Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature

Myoid gonadal stromal tumor of the testis—the novel subtype of testicular gonadal stromal tumors: a case report and review of the literature

Male Infertility and the Risk of Developing Testicular Cancer: A Critical Contemporary Literature Review

Unilateral, Small, Benign, Late-Onset, Large-Cell Calcifying Sertoli Cell Tumor: A Case Report

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