Carefully selected intratesticular lesions can be safely managed with serial ultrasonography
Connolly, Stephen S. D'Arcy, Frank T. Gough, Niall McCarthy, Peter Bredin, Hugh C. Corcoran, Michael O.
Connolly, Stephen S.
D'Arcy, Frank T.
Gough, Niall
McCarthy, Peter
Bredin, Hugh C.
Corcoran, Michael O.
Publication Date
2006-11-01
Type
Article
Downloads
Citation
Connolly, Stephen S. D'Arcy, Frank T.; Gough, Niall; McCarthy, Peter; Bredin, Hugh C.; Corcoran, Michael O. (2006). Carefully selected intratesticular lesions can be safely managed with serial ultrasonography. BJU International 98 (5), 1005-1007
Abstract
OBJECTIVE To evaluate a policy of conservative non-operative management for incidental, impalpable, < 1 cm, intratesticular pathology. PATIENTS AND METHODS We retrospectively reviewed all scrotal ultrasonograms within an 8-year period to identify all radiological lesions of < 1 cm within the testis. All palpable lesions and those accompanied by elevated tumour markers or disseminated malignancy were managed surgically. The remaining incidentally detected lesions were followed with a protocol of serial ultrasonography (US). RESULTS Of 1544 scans reviewed, 12 (0.8%) lesions suitable for observational management were identified. The mean (range) age of the patients was 54 (34-76) years. The indication for US was suspected epididymitis in five, contralateral epididymal cyst in five and infertility in two patients. The mean (range) size of the lesion was 4.9 (1.5-9.8) mm. Three anechoic lesions were consistent with intratesticular cysts, and each was followed with no change to a mean (range) follow-up of 26 (12-48) months. Eight hypoechoic lesions were followed to a mean of 34 (4-72) months, and only one showed growth on repeat US after an interval of 4 months, and was diagnosed as a 1.0-cm seminoma after orchidectomy. One hyperechoic lesion remains unchanged at 6 months of follow-up. CONCLUSION Supported by previous reports suggesting that most testis lesions of < 1 cm are benign, we managed a series of carefully selected intratesticular lesions conservatively, the behaviour in most being in keeping with benign pathology.
Funder
Publisher
Wiley-Blackwell
Publisher DOI
Rights
Attribution-NonCommercial-NoDerivs 3.0 Ireland