Technical report. Intra-operative ultrasound-guided needle localization for impalpable testicular lesions.
OBJECTIVE
To describe a new technique of intra-operative ultrasound-guided needle localization of impalpable intratesticular lesions.


METHODS
Three patients with impalpable testicular lesions identified on ultrasound underwent needle localization under ultrasound guidance. The procedure was performed in the operating theatre under general anaesthetic using a 7.5-8 MHz linear array probe and a portable ultrasound machine. Under direct guidance, a 21 G needle was placed through the centre of the lesion allowing resection and immediate frozen section analysis.


RESULTS
In two patients malignancy was confirmed and an orchidectomy was performed. In one patient a benign lesion was detected obviating the need for orchidectomy.


CONCLUSIONS
Patients presenting with impalpable testicular lesions can pose a diagnostic dilemma and orchidectomy is often performed. We describe an ultrasound-guided intra-operative localization technique enabling direct pathological examination so surgical approach can be re-evaluated in the presence of a benign lesion. This is particularly important in the case of a solitary testicle in order to preserve testicular function.
Browne
R F J
RF
Department of Radiology, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland.
Jeffers
M
M
McDermott
T
T
Grainger
R
R
Mulvin
D
D
Gibney
R G
RG
Torreggiani
W C
WC
D000328:Adult; D001707:Biopsy, Needle; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008297:Male; D009919:Orchiectomy; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D013737:Testis / Q000000981:diagnostic imaging / Q000473:pathology; D018084:Ultrasonography, Interventional