Aims and objectives
Small testicular masses (STMs),
defined as non palpable,
< 25mm diameter mass [1], are a growing problem,
because many cases may be benign at final histology.
Testicular cancer represents between 1% and 1.5% of male neoplasms and 5% of urological tumours in general,
with 3-10 new cases occurring per 100,000 males/per year in Western countries [2-4].
Malignant germ cell neoplasms represent most of the palpable symptomatic testicular masses.
Therefore,
radical orchiectomy has been the standard of care for testicular masses.
However the widespread use of...
Methods and materials
We evaluated 16 patients (pts) positive for STMs (lesion diameter <15 mm) to Ultrasound (US).
Scrotal US is performed with the use of high frequency broadband linear transducer (8-13 MHz) that can perform both power and spectral Doppler ultrasonography.
Baseline gray scale and color Doppler sonographic examinations were performed using an MyLab™70 XVG system (Esaote,
Genoa,
Italy) with LA523 linear array contrast-enabled transducer.
The scrotum and its contents are evaluated in longitudinal and trasverse plans.
All images were stored on an external hard disk for...
Results
The diagnosis was incidental in asymptomatic patients. Neoplastic markers were negative in all pts.
Table 1 shows global data of the clinical and pathologic characteristics of the whole patient population.
Pre-operative sonographic patterns for the individual patients are presented in Table 2.
Sonographic appearance of testicular lesions was heterogeneous with a prevalence of hypoecoic pattern.
Color Doppler signals of the STMs resulted absent except three cases.
CEUS showed lesional absence of contrast enhancement in 2 lesions (Fig.
1),
progressive and weak contrast enhancement in 4...
Conclusion
The widespread use of US for the diagnostic evaluation of scrotal disorders and current advances in US technology have allowed a more frequent detection of incidental testicular lesions.
Recent studies show that,
approximately 80% of non palpable masses are benign [9].
A proper management in differential diagnosis of these benign entities may preclude the need of radical orchiectomy.
In our experience TSS with detailed pre-operative and intra-operative US can be considered a safe procedure,
with an optimal concordance between FS and final pathology.
Although sonographic...
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NORDCAN...