title: Efficacy of ultrasound-guided testicle-sparing surgery for small testicular masses.
abstract: OBJECTIVE
  The aim of the present study was to evaluate evolution of conservative echo-guided surgery for testicular tumours ≤1.5 cm and to assess the safety of this surgical procedure.
  
  
  METHODS
  49 consecutive patients diagnosed with ultrasonography testicular lesions (mono or bilateral) ≤1.5 cm and treated with conservative echo-guided testicular surgery were examined. The parameters considered in this retrospective analysis included case history, physical examination, scrotal and abdominal ultrasonography, computed tomography scan, size of the nodule (maximum diameter), tumour markers, chest radiography, frozen section examination, histologic size of the tumour, overall survival (OS) and findings on follow-up.
  
  
  RESULTS
  Mean age of patients was 33 years (range 18-62). Patients who presented with a palpable testicular nodule were 32.7 %, gynecomastia 10.2 %, precocious pseudopuberty 4 %, and scrotal pain 12.2 %. Permanent section examination confirmed the FSE data in all cases of certainty malignant lesion and definitive histological types were: 22 seminoma, 13 non-seminomatous or mixed germ cell tumours, 4 Leydig tumours, 2 hamartoma, 1 epidermoid cyst, 2 sertoli cell tumours, and 5 fibrous pseudotumour. No complications intra- and postoperative were observed. Overall survival was 100 % and scrotal US showed evidence of local tumour recurrence in 6 patients (12.2 %) after a mean follow-up of 34.7 months.
  
  
  CONCLUSIONS
  The OS, the low rate of local recurrence, and absence of complications, tend to demonstrate the safety of the procedure. The benefits to testicular-sparing surgery include improving the patient's overall quality of life, fertility, endocrine function and negative cosmetic effects of radical orchiectomy.
authors.affiliation: Department of Urology, University Hospital "St.Anna", 8 A. Moro Street, Cona, 44124 Ferrara, Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Dell'Atti
mesh_terms: D000293:Adolescent; D000328:Adult; D014408:Biomarkers, Tumor / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D016019:Survival Analysis; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D014408:Biomarkers, Tumor
keywords: Non-palpable; Small testicular mass; Testicle-sparing surgery; Testicular tumour; Ultrasound