Prevalence and Management of Incidental Testicular Masses—A Systematic Review
Management of incidentally diagnosed small testicular masses (STM) is controversial. Although there is the risk of malignancy, it might be realistic to safely seek preservation of testicles bearing benign masses. This study aims to systematically evaluate the evidence regarding prevalence of STMs, t...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/19/5770 |
| _version_ | 1797478633399386112 |
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| author | Daniel Henriques Anabela Mota Pinto Helena Donato Ricardo Leão |
| author_facet | Daniel Henriques Anabela Mota Pinto Helena Donato Ricardo Leão |
| author_sort | Daniel Henriques |
| collection | DOAJ |
| description | Management of incidentally diagnosed small testicular masses (STM) is controversial. Although there is the risk of malignancy, it might be realistic to safely seek preservation of testicles bearing benign masses. This study aims to systematically evaluate the evidence regarding prevalence of STMs, their benign or malignant histology and their management. We conducted a systematic literature search for studies reporting small or incidental testicular masses and their management by radical orchiectomy, testis sparing surgery (TSS) or ultrasound (US) surveillance. We initially screened 2126 abstracts and from these, 57 studies met the inclusion criteria. Testicular masses were detected in 1.74% of patients undergoing US examination. Regarding STMs removed by surgery, 41.12% were benign. Intraoperative frozen section examination (FSE) is a reliable tool to discriminate between benign and malignant testicular masses (average 93.05% accuracy), supporting TSS. Benign lesions were associated with smaller diameter (<1 cm 68.78% benign), were often hypoechoic and exhibited regular margins on US. Conclusions: Small testicular masses are often benign. Clinical and US patterns are not accurate enough for including patients in surveillance protocols and TSS paired with FSE is pivotal for precluding the removal of testicles bearing benign lesions. Future research might unveil new imaging tools or biomarkers to support clinical management. |
| first_indexed | 2024-03-09T21:34:29Z |
| format | Article |
| id | doaj.art-95df94d5546949529ba7bc9c9451e6e7 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T21:34:29Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-95df94d5546949529ba7bc9c9451e6e72023-11-23T20:48:29ZengMDPI AGJournal of Clinical Medicine2077-03832022-09-011119577010.3390/jcm11195770Prevalence and Management of Incidental Testicular Masses—A Systematic ReviewDaniel Henriques0Anabela Mota Pinto1Helena Donato2Ricardo Leão3Faculdade de Medicina, Universidade de Coimbra, 3004-540 Coimbra, PortugalFaculdade de Medicina, Universidade de Coimbra, 3004-540 Coimbra, PortugalDocumentation and Scientific Information Service, Centro Hospitalar e Universitário de Coimbra, 3004-561 Coimbra, PortugalFaculdade de Medicina, Universidade de Coimbra, 3004-540 Coimbra, PortugalManagement of incidentally diagnosed small testicular masses (STM) is controversial. Although there is the risk of malignancy, it might be realistic to safely seek preservation of testicles bearing benign masses. This study aims to systematically evaluate the evidence regarding prevalence of STMs, their benign or malignant histology and their management. We conducted a systematic literature search for studies reporting small or incidental testicular masses and their management by radical orchiectomy, testis sparing surgery (TSS) or ultrasound (US) surveillance. We initially screened 2126 abstracts and from these, 57 studies met the inclusion criteria. Testicular masses were detected in 1.74% of patients undergoing US examination. Regarding STMs removed by surgery, 41.12% were benign. Intraoperative frozen section examination (FSE) is a reliable tool to discriminate between benign and malignant testicular masses (average 93.05% accuracy), supporting TSS. Benign lesions were associated with smaller diameter (<1 cm 68.78% benign), were often hypoechoic and exhibited regular margins on US. Conclusions: Small testicular masses are often benign. Clinical and US patterns are not accurate enough for including patients in surveillance protocols and TSS paired with FSE is pivotal for precluding the removal of testicles bearing benign lesions. Future research might unveil new imaging tools or biomarkers to support clinical management.https://www.mdpi.com/2077-0383/11/19/5770incidental findingstesticular neoplasmsultrasonographyfrozen sectionswatchful waiting |
| spellingShingle | Daniel Henriques Anabela Mota Pinto Helena Donato Ricardo Leão Prevalence and Management of Incidental Testicular Masses—A Systematic Review Journal of Clinical Medicine incidental findings testicular neoplasms ultrasonography frozen sections watchful waiting |
| title | Prevalence and Management of Incidental Testicular Masses—A Systematic Review |
| title_full | Prevalence and Management of Incidental Testicular Masses—A Systematic Review |
| title_fullStr | Prevalence and Management of Incidental Testicular Masses—A Systematic Review |
| title_full_unstemmed | Prevalence and Management of Incidental Testicular Masses—A Systematic Review |
| title_short | Prevalence and Management of Incidental Testicular Masses—A Systematic Review |
| title_sort | prevalence and management of incidental testicular masses a systematic review |
| topic | incidental findings testicular neoplasms ultrasonography frozen sections watchful waiting |
| url | https://www.mdpi.com/2077-0383/11/19/5770 |
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