title: The Value of Active Ultrasound Surveillance for Patients With Small Testicular Lesions.
abstract: This study aimed to determine whether active ultrasound surveillance may obviate the need for surgical resection in selected patients with small testicular lesions (STLs). A retrospective 11-year review was conducted of adults who were diagnosed with an STL on scrotal ultrasonography and who either had orchiectomy or sonographic follow-up during a period of at least 3 months. A total of 101 subjects were enrolled. Ultrasound findings, clinical features, histopathology/follow-up imaging were recorded. Logistic regression analysis was performed to select independent risk factors for the diagnosis of malignancy. Seventeen (16.8%) subjects underwent immediate surgery, 8 (7.9%) of 101 underwent surgery after ultrasound follow-up, and 76 (75.3%) of 101 were followed with ultrasound only. The follow-up period ranged from 1 to 7 months in the 8 patients who ultimately underwent surgery after ultrasound follow-up and from 6 to 84 months in the 76 patients followed up with ultrasound only. All 15 malignant cases underwent immediate surgery without follow-up sonography. The frequency of lesions, either benign at surgery or stable on ultrasound, was 85.1% (86 of 101; 95% confidence interval, 77%-91%). Logistic regression analysis showed that lesion size was the only independent risk factor for malignancy in hypoechoic STLs (P < 0.05). Most of the STLs were stable on serial sonograms and likely benign. Active ultrasound surveillance may be an appropriate management strategy in patients with STLs.
authors: *Department of Ultrasound, Peking University First Hospital, Peking University Health Science Center, Beijing, China; †Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; and ‡Department of Ultrasound, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors: Qian
authors: Q
authors: Li
authors: Abhinav
authors: A
authors: Vij
authors: Peter F
authors: PF
authors: Hahn
authors: Feixiang
authors: F
authors: Xiang
authors: Anthony E
authors: AE
authors: Samir
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000601:surgery; D013737:Testis / Q000000981:diagnostic imaging / Q000601:surgery; D014463:Ultrasonography / Q000379:methods*; D055815:Young Adult