Management of nonpalpable testicular tumors.
OBJECTIVE
To report our series of nonpalpable testicular tumors with a review of published studies. Radical orchiectomy remains the reference standard in the treatment of a solid testicular mass. Testis-sparing surgery has recently been advocated for a select group of patients with nonpalpable tumors.


METHODS
Between 1998 and 2002, a nonpalpable testicular mass was discovered in 9 patients. Ultrasonography was performed for infertility evaluation (5 patients), testicular pain (3 patients), and retroperitoneal lymphadenopathy (1 patient).


RESULTS
Radical orchiectomy was performed in 7 of 9 patients and testis-sparing surgery with microsurgical excision of tumor in 1 patient. One patient decided against surgery. A benign testicular tumor was found in 6 and a malignant tumor in 2 of the 8 patients.


CONCLUSIONS
A high incidence of benign nonpalpable tumor and an advanced microsurgical technique justifies organ-sparing surgery as an alternative for radical orchiectomy in a select group of patients. Testicular preservation in patients with a malignant nonpalpable testicular tumor is a feasible, but still controversial, approach.
Sheynkin
Yefim R
YR
Department ofUrology, Health Science Center, State University of New York at Stony Brook, Stony Brook, New York 11794-8093, USA.
Sukkarieh
Troy
T
Lipke
Michael
M
Cohen
Harris L
HL
Schulsinger
David A
DA
D000293:Adolescent; D000328:Adult; D018237:Germinoma / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007248:Infertility, Male / Q000209:etiology; D007984:Leydig Cell Tumor / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D042282:Microdissection; D009919:Orchiectomy; D010146:Pain / Q000209:etiology; D010173:Palpation; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography