title: Management of nonpalpable testicular tumors.
abstract: 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.
authors.affiliation: Department ofUrology, Health Science Center, State University of New York at Stony Brook, Stony Brook, New York 11794-8093, USA.
authors.forename: Yefim R
authors.initials: YR
authors.lastname: Sheynkin
authors.forename: Troy
authors.initials: T
authors.lastname: Sukkarieh
authors.forename: Michael
authors.initials: M
authors.lastname: Lipke
authors.forename: Harris L
authors.initials: HL
authors.lastname: Cohen
authors.forename: David A
authors.initials: DA
authors.lastname: Schulsinger
mesh_terms: 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