Document Detail

Impalpable testis cancer.
MedLine Citation:
PMID:  14511036     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To assess the significance of ultrasonographically detected hypoechoic lesions of the testis when the clinical examination is normal, and to highlight the management difficulties thereafter. PATIENTS AND METHODS: Over a 2-year period four patients underwent radical orchidectomy where the sole indication for surgery was a hypoechoic lesion detected on ultrasonography (US). The indications for US were persistent scrotal discomfort in two men, contralateral orchitis, and the follow-up of testicular microlithiasis. The lesions were 4-11 mm in size and one man had several. None of the lesions were palpable; the tumour markers were normal in all patients. RESULTS: Three of the testes contained seminoma; in one there were two foci of seminoma and in all intratubular germ cell neoplasia was also identified. The remaining case was a Leydig-cell tumour. All tumours were staged as pT1 after radical inguinal orchidectomy. CONCLUSION: Impalpable lesions of the testis are likely to be malignant if they are hypoechoic on US and should be considered as seminoma until proved otherwise. The management thereafter is not straightforward, but must ensure an adequate histological diagnosis if the US appearances do not resolve.
R G Hindley; A Chandra; A Saunders; T S O'Brien
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJU international     Volume:  92     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2003 Oct 
Date Detail:
Created Date:  2003-09-26     Completed Date:  2003-10-30     Revised Date:  2006-07-18    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  572-4     Citation Subset:  IM    
Department of Urology, Guy's Hospital, St Thomas Street, London, UK.
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MeSH Terms
Follow-Up Studies
Leydig Cell Tumor / pathology,  ultrasonography
Seminoma / pathology,  ultrasonography*
Testicular Neoplasms / pathology,  ultrasonography*
Comment In:
BJU Int. 2004 Apr;93(6):888   [PMID:  15050017 ]
BJU Int. 2004 Apr;93(6):887-8   [PMID:  15050016 ]
BJU Int. 2004 Mar;93(4):638   [PMID:  15008754 ]

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