Artigo Revisado por pares

High Incidence of Benign Testicular Neoplasms Diagnosed by Ultrasound

2003; Lippincott Williams & Wilkins; Volume: 170; Issue: 5 Linguagem: Inglês

10.1097/01.ju.0000092066.01699.90

ISSN

1527-3792

Autores

Luca Carmignani, Franco Gadda, Giacomo Gazzano, F Nerva, Mario Mancini, M Ferruti, Gaetano Bulfamante, Silvano Bòsari, Guido Coggi, Francesco Rocco, Giovanni M. Colpi,

Tópico(s)

Genital Health and Disease

Resumo

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2003High Incidence of Benign Testicular Neoplasms Diagnosed by Ultrasound LUCA CARMIGNANI, FRANCO GADDA, GIACOMO GAZZANO, FRANCO NERVA, MARIO MANCINI, MARIO FERRUTI, GAETANO BULFAMANTE, SILVANO BOSARI, GUIDO COGGI, FRANCESCO ROCCO, and GIOVANNI MARIA COLPI LUCA CARMIGNANILUCA CARMIGNANI , FRANCO GADDAFRANCO GADDA , GIACOMO GAZZANOGIACOMO GAZZANO , FRANCO NERVAFRANCO NERVA , MARIO MANCINIMARIO MANCINI , MARIO FERRUTIMARIO FERRUTI , GAETANO BULFAMANTEGAETANO BULFAMANTE , SILVANO BOSARISILVANO BOSARI , GUIDO COGGIGUIDO COGGI , FRANCESCO ROCCOFRANCESCO ROCCO , and GIOVANNI MARIA COLPIGIOVANNI MARIA COLPI View All Author Informationhttps://doi.org/10.1097/01.ju.0000092066.01699.90AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the clinical and histological significance of incidental ultrasonographic focal testicular lesions and assessed whether a conservative surgical approach may put the patient at higher oncological risk due to insufficient surgical eradication. Materials and Methods: From October 2000 to May 2002 all patients with infertility, scrotal swelling, scrotal pain, varicocele, scrotal trauma or erectile dysfunction underwent scrotal ultrasonography. A total of 1,320 patients were investigated. Focal testicular lesions were found in 27 patients (2%), palpable nodules were present in 17 (63%) and nonpalpable incidental lesions were diagnosed in 10. Nodule diameter was 3 to 24 mm. All patients underwent explorative surgery via inguinotomy and preventive clamping of the spermatic cord. The nodules were completely removed with biopsy of the resection margins. Nonpalpable lesions were removed under ultrasonographic guidance. The testicle was only preserved when frozen section revealed a benign lesion and margins were negative. Results: Of the 17 cases of palpable lesions (diameter 3 to 24 mm) conservative surgery was performed in 8 (47%). Definitive histological diagnosis showed Leydig cell tumor in 2 (25%), and large cell calcifying Sertoli’s cell tumor, adenomatoid tumor, pseudofibrotic tumor of the tunica albuginea, epidermoid cyst, tubular fibrosis and nonHodgkin’s lymphoma in each 1 (12.5%). The remaining 9 patients (53%) underwent orchidectomy. Definitive histological examination revealed pure seminoma in 4 patients (44%), embryonal carcinoma in 4 (44%) and diffuse Leydig cell hyperplasia in 1 (12%). Seven of the 10 pts (70%) with nonpalpable nodules (diameter 4 to 16 mm) underwent conservative surgery. Histological study revealed focal Leydig cell hyperplasia in 1 case (10%), fibrosis in 3 (30%), infarction in 2 (20%) and mesothelial hyperplasia in 1 (10%). Orchiectomy was performed in the remaining 3 pts. Histology showed diffuse Leydig cell tumor in 2 pts (20%) and adenomatoid tumor with abscessed areas in 1 (10%). Neither atrophy nor local relapse was observed in pts who underwent conservative treatment during followup (mean: 1 month, range 19 to 9). Conclusions: The incidental diagnosis of testicular ultrasound alterations is increasing and 80% show a benign histology. In these cases a conservative surgical approach is the best option and it does not expose the patient to the risk of relapse. References 1 : Should all infertile males undergo urologic evaluation before assisted reproductive technologies? Two cases of testicular cancer presenting with infertility. Fertil Steril2001; 75: 1226. Google Scholar 2 : Management of testicular masses incidentally discovered by ultrasound. J Urol1994; 151: 1263. Link, Google Scholar 3 : Follow-up after radical orchiectomy for testicular cancer. Urol Clin North Am1994; 21: 757. Google Scholar 4 : Nonpalpable intratesticular masses detected sonographically. J Urol1995; 154: 1367. Link, Google Scholar 5 : The indications for scrotal ultrasound. Br J Radiol1999; 72: 833. Google Scholar 6 : Is routine scrotal ultrasound advantageous in infertile men?. J Urol1999; 162: 1618. Link, Google Scholar 7 : Benign intratesticular cystic lesions: US features. Radiographics2001; 21: S273. Google Scholar 8 : The ultrasound investigation of scrotal swelling. Int J STD AIDS2000; 11: 297. Google Scholar 9 : Sonographic and MR imaging findings of testicular epidermoid cysts. AJR Am J Roentgenol2002; 178: 743. Google Scholar 10 : Ultrasound guided needle localization and microsurgical exploration for incidental nonpalpable testicular tumors. J Urol2002; 168: 1084. Link, Google Scholar 11 : Accuracy of frozen section examination of testicular tumors of uncertain origin. Eur Urol2002; 41: 290. Google Scholar 12 : Large cell calcifying Sertoli cell tumor of the testis: contrasting features of six malignant and six benign tumors and a review of the literature. Am J Surg Pathol1997; 21: 1271. Google Scholar 13 : Case report: congenital adrenal hyperplasia and malignant Leydig cell tumor. Am J Med Sci1995; 309: 63. Google Scholar 14 : Benign fibromatous tumors of the testis and paratesticular region: a report of 9 cases with a proposed classification of fibromatous tumors and tumor-like lesions. Am J Surg Pathol1997; 21: 296. Google Scholar From the Urology (LC, FG, MF, FR) and Pathology (GG, GB, SB, GC) Units, Department of Medicine, Surgery and Dental Sciences and Andrology Unit, University of Milan (GMC), San Paolo Hospital (FN, MM) and Istituto di Ricerca e Cura a Carattere Scientifico Ospedale Maggiore, Milan, Italy© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byKoehne E and Patel H (2021) Editorial CommentaryUrology Practice, VOL. 9, NO. 1, (78-79), Online publication date: 1-Jan-2022.Gentile G, Rizzo M, Bianchi L, Falcone M, Dente D, Cilletti M, Franceschelli A, Vagnoni V, Garofalo M, Schiavina R, Brunocilla E, Claps F, Liguori G, Trombetta C, Timpano M, Rolle L, Porreca A, Leonardo C, De Nunzio C, Colombo F and Franco G (2019) Testis Sparing Surgery of Small Testicular Masses: Retrospective Analysis of a Multicenter CohortJournal of Urology, VOL. 203, NO. 4, (760-766), Online publication date: 1-Apr-2020.Paffenholz P, Held L, Loosen S, Pfister D and Heidenreich A (2018) Testis Sparing Surgery for Benign Testicular Masses: Diagnostics and Therapeutic ApproachesJournal of Urology, VOL. 200, NO. 2, (353-360), Online publication date: 1-Aug-2018.Bieniek J, Juvet T, Margolis M, Grober E, Lo K and Jarvi K (2017) Prevalence and Management of Incidental Small Testicular Masses Discovered on Ultrasonographic Evaluation of Male InfertilityJournal of Urology, VOL. 199, NO. 2, (481-486), Online publication date: 1-Feb-2018.Toren P, Roberts M, Lecker I, Grober E, Jarvi K and Lo K (2010) Small Incidentally Discovered Testicular Masses in Infertile Men—Is Active Surveillance the New Standard of Care?Journal of Urology, VOL. 183, NO. 4, (1373-1377), Online publication date: 1-Apr-2010.Eifler J, King P and Schlegel P (2008) Incidental Testicular Lesions Found During Infertility Evaluation are Usually Benign and May be Managed ConservativelyJournal of Urology, VOL. 180, NO. 1, (261-265), Online publication date: 1-Jul-2008.Powell T and Tarter T (2018) Management of Nonpalpable Incidental Testicular MassesJournal of Urology, VOL. 176, NO. 1, (96-99), Online publication date: 1-Jul-2006.CARMIGNANI L, MORABITO A, GADDA F, BOZZINI G, ROCCO F and COLPI G (2018) PROGNOSTIC PARAMETERS IN ADULT IMPALPABLE ULTRASONOGRAPHIC LESIONS OF THE TESTICLEJournal of Urology, VOL. 174, NO. 3, (1035-1038), Online publication date: 1-Sep-2005.CARMIGNANI L, GADDA F, MANCINI M, GAZZANO G, NERVA F, ROCCO F and COLPI G (2018) DETECTION OF TESTICULAR ULTRASONOGRAPHIC LESIONS IN SEVERE MALE INFERTILITYJournal of Urology, VOL. 172, NO. 3, (1045-1047), Online publication date: 1-Sep-2004. Volume 170Issue 5November 2003Page: 1783-1786 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordstestistesticular neoplasmsultrasonographyincidental findingsMetricsAuthor Information LUCA CARMIGNANI More articles by this author FRANCO GADDA More articles by this author GIACOMO GAZZANO More articles by this author FRANCO NERVA More articles by this author MARIO MANCINI More articles by this author MARIO FERRUTI More articles by this author GAETANO BULFAMANTE More articles by this author SILVANO BOSARI More articles by this author GUIDO COGGI More articles by this author FRANCESCO ROCCO More articles by this author GIOVANNI MARIA COLPI More articles by this author Expand All Advertisement PDF downloadLoading ...

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