RE: The value of testicular ultrasound in the prediction of the type and size of testicular tumors
We read with great interest the article “The value of testicular ultrasound in the prediction of the type and size of testicular tumors” by Shtricker A. et al (1). This article highlights an interesting role of testicular ultrasound finding in managing testicular tumor, particularly regarding the...
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| Format: | Article |
| Language: | English English English |
| Published: |
Brazilian Society of Urology
2016
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/50705/1/Letter_Shtricker_397_398.pdf http://irep.iium.edu.my/50705/4/50705-RE_The_value_of_testicular_ultrasound_SCOPUS.pdf http://irep.iium.edu.my/50705/5/50705-RE_The_value_of_testicular_ultrasound_WOS.pdf |
| Summary: | We read with great interest the article “The value of testicular ultrasound in the prediction
of the type and size of testicular tumors” by Shtricker A. et al (1). This article highlights
an interesting role of testicular ultrasound finding in managing testicular tumor, particularly
regarding the ability of testicular ultrasound to differentiate between these three lesions: benign
lesion, seminomatous germ cell tumor (SGCT) and non-seminomatous germ tumor (NSGCT). The
presence of necrosis is more suggestive of malignant tumors, whereas hypoechogeneity and fibrosis
on testicular ultrasound are more suggestive of SGCT type (1). These finding will increase
the ability to differentiate type of testicular tumor preoperatively in addition to traditionally use
tumor markers. Hopefully in near future the characteristic of different type of cancers can be
done to form risk stratification Table.
On the other hand, this article gives us a big doubt regarding the ability of preoperative
ultrasound to estimate the tumor size as compared to pathological measurement. It was
not verified the actual time interval between diagnostic ultrasound and the orchiectomy. Fast
growing cancer will give significant change in size within short period of time. Thus, the ultrasound
findings will be smaller in comparison to pathological size if the time interval between
the ultrasound and operation was a week or more. In contrast to malignant lesion, the benign
lesion was well documented as slow growing and expected to have similar size during diagnostic
ultrasound and pathological specimen regardless the time interval; as shown in this study
that 100% of benign tumors showed similar sizes for both measurements (1, 2). Furthermore,
the study was conducted in multicentre which will give more varieties in term of technique as
ultrasound requires a highly experienced and skilled operator, as well as advance equipment (3).
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