title: Reliability of Frozen Section Examination in a Large Cohort of Testicular Masses: What Did We Learn?
abstract: Frozen section examination (FSE) for testicular masses is gaining popularity because of the possibility of performing testis-sparing surgery (TSS) on the basis of the FSE results. The aim of our study was to investigate the reliability of FSE in the diagnosis of testicular masses.
  
  
  
  From 1999 to 2016, 144 of 692 patients who underwent surgery in our tertiary center for testicular masses had FSE. The indications for FSE were: masses < 1 cm, nonpalpable, multiple, or with unusual presentation. Mean follow-up for patients was 25.5 months. The algorithm of surgery determined by FSE was: orchiectomy if malignant or nonconclusive pathology; TSS if benign or nontumor pathology. FSE data were analyzed retrospectively. Specificity and sensitivity of the method was calculated for benign, malignant, seminoma, and nonseminoma tumors.
  
  
  
  Intraoperative FSE was conducted on 21% of candidates for surgery on testicular masses. The sensitivity and specificity of FSE were 93% and 98%, respectively, for malignant tumors, and 90% and 99%, respectively, for benign tumors. The κ agreement coefficient between FSE and final histopathology was statistically significant (0.76). TSS was performed in 57 (40%) patients, including 6 of 23 monorchid patients.
  
  
  
  FSE correlates well with final histopathological diagnosis of testicular masses. Thus, it reliably identifies patients who might benefit from TSS. FSE should be considered always in small, nonpalpable, multiple, or uncommonly presenting masses in solitary testis or both testes.
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Deliu Victor
authors.initials: DV
authors.lastname: Matei
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy; Department of Cell and Molecular Biology, University of Medicine and Pharmacy, Targu Mures, Romania.
authors.forename: Mihai Dorin
authors.initials: MD
authors.lastname: Vartolomei
authors.affiliation: Department of Laboratory and Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Renne
authors.affiliation: University of Milan, Milan, Italy.
authors.forename: Valeria Maria Lucia
authors.initials: VML
authors.lastname: Tringali
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Russo
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Bianchi
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Cozzi
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Danilo
authors.initials: D
authors.lastname: Bottero
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Musi
authors.affiliation: Department of Laboratory and Pathology, European Institute of Oncology, Milan, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Mazzarol
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy. Electronic address: matteo.ferro@ieo.it.
authors.forename: Matteo
authors.initials: M
authors.lastname: Ferro
authors.affiliation: Division of Urology, European Institute of Oncology, Milan, Italy; University of Milan, Milan, Italy.
authors.forename: Ottavio
authors.initials: O
authors.lastname: de Cobelli
mesh_terms: D000328:Adult; D000465:Algorithms; D015331:Cohort Studies; D005629:Frozen Sections; D006801:Humans; D008297:Male; D009919:Orchiectomy / Q000379:methods; D059351:Organ Sparing Treatments; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery*
keywords: Frozen section; Orchiectomy; Small testicular masses; Testicle; Testis-sparing surgery