Surgico-pathological analysis of testicular lesions

Abstract

The primary objective of our study was to identify the different types of histopathological lesions of testes and epididymis occurring in patients admitted in a tertiary care hospital, the objective was also to analyze the spectrum of testicular lesions, our aim was to evaluate the prevalence of testicular malignancies and characterize the tumor based on their histo-morphological features. This was a prospective study of 2 years (October 2018 to October 2020) aggregating a total of 52 cases. The surgical specimens were referred to the pathology department for histopathological analysis. Adetailed preoperative history of every case with regards to age, presenting symptoms, and signs along with personal history were obtained.Also, relevant investigations like serum tumor markers and Ultrasonography findings were analyzed. Postoperatively, the tissue was sent to the histopathology department was studied by proper fixation, gross examination, adequate sampling, and paraffin sections of the same.10% formalin was used to fix the specimen. Some resources suggest the use of Bouin solution for the fixation of testis biopsy specimens. However, the picric acid in the Bouin solution presents challenges for safe handling and disposal due to its explosive potential.Hence, given the available resources in our laboratory setting, formalin was the preferred choice of fixative. We ensured that the specimens came in adequate amount of formalin from the OT with correct labeling.We excluded the autolyzed specimens. The data was noted and quantitative analysis was done.The study was further compared with other previously reported studies. 52 cases were studied and majority of the cases were reported in the age group of 31-40yrs. 65.4% cases were non neoplastic, with testicular torsion being the commonest lesion. Amongthe 23.1% neoplastic cases that were reported, mixed germ cell tumor was the commonest (75%). Non neoplastic lesions are more common than neoplastic lesions. Torsion testis was the commonest indication for orchidectomy in younger age group. Despite newer techniques in imaging and tumor marker assays the diagnosis of testicular lesions is primarily dependent upon histopathological examination.