Testicular lesions other than germ cell tumours: feasibility of testis-sparing surgery.
OBJECTIVE
To review all non-germ-cell testicular lesions presenting at our institution and to determine the feasibility of testis-sparing surgery for these patients.


METHODS
All surgery for testicular masses between June 1995 and June 2005 were reviewed retrospectively. Patients with atrophy, germ cell tumours, infection or torsion were excluded. The study comprised men who had radical orchidectomy for suspected germ-cell tumour but had other final pathology, and those where testis-sparing surgery was attempted for a presumed benign lesion.


RESULTS
Thirteen patients with lesions appropriate for the study were identified; all but one had a palpable lesion. The lesions could be categorized as inflammatory (three hyalinized fibrosis, two sarcoidosis, one chronic inflammation), cystic (one epidermoid cyst, one unilocular cyst), benign neoplasms (two adenomatoid tumours, one Leydig cell tumour, one capillary haemangioma) or malignant neoplasms (one lymphoma). Based on the preoperative impression, testis-sparing surgery was attempted in eight of the lesions and was successful in six where it was attempted. In the other five, testis-sparing surgery was not attempted because the preoperative impression was that of a germ cell tumour. Testis-sparing surgery was successful in only six of the 13 patients with these lesions.


CONCLUSIONS
Testis-sparing surgery might be possible if there is significant suspicion of a benign lesion. If frozen-section analysis is equivocal, a radical orchidectomy is required. Testis-sparing surgery was feasible in highly selected cases.
Passman
Corey
C
Department of Surgery/Urology, University of Alabama at Birmingham, AL 35294-3411, USA.
Urban
Donald
D
Klemm
Katrin
K
Lockhart
Mark
M
Kenney
Phillip
P
Kolettis
Peter
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D005240:Feasibility Studies; D006801:Humans; D007984:Leydig Cell Tumor / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000473:pathology / Q000601:surgery; D009919:Orchiectomy / Q000379:methods*; D012189:Retrospective Studies; D013733:Testicular Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013737:Testis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome; D014463:Ultrasonography; D055815:Young Adult