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Surveillance Feasible for Small Testicular Masses

Ultrasound follow-up may be safe alternative to surgery for incidental masses

THURSDAY, April 29 (HealthDay News) -- In men with incidental testicular masses less than 1 cm in size, ultrasound surveillance may be a safe alternative to immediate surgical removal, according to a study published in the April issue of The Journal of Urology.

Paul J. Toren, M.D., of the University of Toronto, and colleagues studied 46 patients who had hypoechoic, intratesticular masses that had a maximal dimension of 1 cm or less. Thirty-nine of the patients presented with infertility. Ultrasound follow-up lasted a mean 253 days, and the mean number of ultrasounds was 2.8

In the 38 patients who received serial ultrasound follow-up, the researchers observed a mean lesion growth of 0.5 mm per year. They also found that only one patient had seminoma detected by growth on interval ultrasound, and stated that he continues to be recurrence-free. Three patients immediately had surgery, and five had surgery after an ultrasound follow-up period. In six patients, the indication for surgery was patient choice, and in two it was interval growth. Presence of vascular flow and larger size were both linked to intervention. One patient had radical orchiectomy for pure seminoma identified because of interval growth from 3 to 6 mm at three months. The seven other patients underwent partial orchiectomy for masses that were found to be benign.

"Based on this study and a review of the literature we now offer active surveillance with ultrasound monitoring to men who have the finding of a small testicular mass on ultrasound," the authors write.

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