Nine cases of nonpalpable testicular mass: an incidental finding in a large scale ultrasonography survey

Abstract

Nonpalpable testicular masses are usually diagnosed during routine ultrasonography (US) examinations for other conditions. There are conflicting results on the final diagnosis and management of these lesions. In the present study we report the results of a large US series of 5104 patients on nonpalpable testicular masses and discuss the management of these patients. This retrospective observational study was performed in a secondary care military hospital. A total of 5104 patients underwent a US and 11 of them were diagnosed as having a nonpalpable testicular mass. These 11 patients also underwent magnetic resonance imaging (MRI). Two of them refused surgery and were excluded from the study. The remaining nine patients underwent intraoperative US-guided localization and excisional biopsy of the non-palpable testicular parenchymal mass. A radical orchiectomy was required in all of them. US and MRI findings, frozen and final pathology results were recorded. The median age of study subjects was 24 years. The final pathology revealed a malign tumor in eight patients and an inflammatory mass in one patient. There were inconsistent results in four patients between frozen section analysis and final pathology. MRI improved the definition of the solid masses in all patients. MRI enhances the certainty of the diagnosis of malignity in nonpalpable testicular masses, particularly in conditions that generally can not be diagnosed with ultrasonography alone. Frozen section analysis is not an accredited method in diagnosing malign lesions in non-palpable testicular masses.