title: [Testicular nodules of infertile men and contrast enhanced ultrasonography: preliminary study].
abstract: BACKGROUND
  The incidence of testicular nodules discovered during infertility evaluation is increasing. These nodules are suspicious of malignancy. There is no paraclinical examination which allows histological orientation to these nodules. The recommendations propose priority treatment by total orchidectomy.
  
  
  METHODS
  Through a retrospective cohort study of infertile patients, our goal is to study the enhancement of testicular nodules after injection of ultrasound contrast. The secondary objective is to determine whether CEUS may argue in favor of conservative treatment. From june 2010 to march 2013, 24 patients had underwent ultrasound contrast study of abnormal testicular parenchyma detected prior to infertility evaluation carried ultrasound. The characteristics of ultrasound enhancement were correlated with the pathological findings of surgical patients and proposed treatments (surgery or surveillance).
  
  
  RESULTS
  Fifteen patients were followed up, 9 were operated (7 partial orchidectomies, 2 total orchidectomies). Histological analysis found four Leydig cell tumors, 2 Sertoli cell tumors and 3 seminomas. No adverse changes were noted during the follow-up. This study showed a typical semiology of early, intense and homogeneous enhancement with a phenomenon of wash in 100% of Leydig cell tumors. All Leydig cell tumors have been treated by partial orchidectomy. Seminomas have intense enhancement in 100% of cases. There was a phenomenon of wash in 2 out of 3 cases. When a wash in was described, it was always described as heterogeneous. All seminomas were finally treated by total orchidectomy. The sensitivity and positive predictive value of ultrasound intense enhancement for the diagnosis of testicular cancer was 89% (Se) and 80% (PPV).
  
  
  CONCLUSIONS
  There is a semiology of ultrasound enhancement of testicular nodules with features that can guide in favor of a malignant tumor, seminoma or Leydig cell tumor. If a prospective study was undertaken, these arrangements could guide us to treatments promoting preservation of the testicular parenchyma.
authors: Service d'urologie, hôpital Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille, France. Electronic address: paul.vandaele@hotmail.fr.
authors: P
authors: P
authors: Vandaele
authors: Service d'andrologie, hôpital Calmette, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France.
authors: F
authors: F
authors: Marcelli
authors: Service d'urologie, hôpital Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille, France.
authors: A
authors: A
authors: Ouzzane
authors: Service d'uroradiologie, hôpital Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille, France.
authors: P
authors: P
authors: Puech
authors: Service d'urologie, hôpital Huriez, CHRU de Lille, 1, place de Verdun, 59037 Lille, France.
authors: A
authors: A
authors: Villers
authors: Service d'andrologie, hôpital Calmette, CHRU de Lille, boulevard du Professeur-Jules-Leclercq, 59037 Lille, France.
authors: J-M
authors: JM
authors: Rigot
mesh_terms: D000328:Adult; D003287:Contrast Media / Q000008:administration & dosage*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D007248:Infertility, Male / Q000209:etiology*; D007984:Leydig Cell Tumor / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D008297:Male; D009919:Orchiectomy; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018239:Seminoma / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D012680:Sensitivity and Specificity; D012707:Sertoli Cell Tumor / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D013736:Testicular Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery; D016896:Treatment Outcome; D018615:Ultrasonography, Doppler, Color / Q000379:methods*
chemical_list: D003287:Contrast Media
keywords: Cancer du testicule; Contrast enhanced ultrasonography (CEUS); Infertility; Infertilité; Nodule testiculaire; Testicular cancer; Testicular nodule; Échographie de contraste