PD01-10 RESULTS OF A CONSERVATIVE APPROACH TO TESTICULAR TUMOURS DISCOVERED DURING INFERTILITY MANAGEMENT
Samuel Lagabrielle, Xavier Durand, Stéphane Droupy, Vincent Izard, francois marcelli, É. Huyghe, Jean-Marie Ferrière, L. Ferretti · The Journal of Urology · 2018
You have accessJournal of UrologyInfertility: Therapy I1 Apr 2018PD01-10 RESULTS OF A CONSERVATIVE APPROACH TO TESTICULAR TUMOURS DISCOVERED DURING INFERTILITY MANAGEMENT Samuel Lagabrielle, Xavier Durand, Stephane Droupy, Vincent Izard, François Marcelli, Eric Huyghe, Jean-Marie Ferriere, and Ludovic Ferretti Samuel LagabrielleSamuel Lagabrielle More articles by this author , Xavier DurandXavier Durand More articles by this author , Stephane DroupyStephane Droupy More articles by this author , Vincent IzardVincent Izard More articles by this author , François MarcelliFrançois Marcelli More articles by this author , Eric HuygheEric Huyghe More articles by this author , Jean-Marie FerriereJean-Marie Ferriere More articles by this author , and Ludovic FerrettiLudovic Ferretti More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.223AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Testicular tumors discovered during systematic infertility workup are often small and non-palpable. A conservative approach so as to spare healthy testis parenchyma in this population should not be a substitute for the oncological principles. This study aimed to evaluate the pathological features of the testis tumours and the sparing surgery results on infertile men. METHODS We retrospectively pooled, from 4 andrology referral centers, 32 patients diagnosed with testis mass during regular infertility workup and who underwent a testis sparing surgery (TSS). Patients included were of all ages and consulted for infertility issues with an impaired sperm analysis. The regular infertility workup included a physical examination, a testis ultrasound and a blood test for sex hormones. The TSS was done in accordance to the oncological principles. A frozen section examination (FSE) was also sent to pathology during the procedures. RESULTS Mean age was 36 (IQR 32 – 37). Half of the patients had azoospermia (16/32) and the other half suffered from oligo-astheno-teratospermia. The mean largest tumoral diameter measured on the ultrasound was 8.5 (IQR 5 – 10). A total of 25% (8/32) of patients had a malignant tumour (seminoma 7/32, 22%; teratoma 1/32, 3%) and 75% (24/32) had a benign lesion (Leydig cell tumour 23/32, 72%; scar tissue 1/32, 3%). The FSE exhibited a positive predictive value (PPV) of 100% and a sensitivity of 43% for the detection of malignant lesions. Globally, the FSE matched the final pathology in 75% of the cases. Of the 8/32 patients (25%) with a malignant tumor, 6 underwent a complementary total orchiectomy and 2 had an additional radiotherapy. With a mean follow up of 26.1 months (IQR 8 – 31.3), one patient (3%) had an homolateral recurrence, which was a Leydig cell tumour. Not a single patient developed metastasis. One patient fathered a child (3%). CONCLUSIONS In this multicentre study, 3/4 of the tumours randomly discovered during infertility management were of a benign pathology. The FSE for the detection of a malignant contingent did not seem fully reliable but an orchiectomy may safely still be performed after the TSS. Thus, a conservative approach to testicular tumours discovered during infertility management could be proposed from the get go. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e63 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Samuel Lagabrielle More articles by this author Xavier Durand More articles by this author Stephane Droupy More articles by this author Vincent Izard More articles by this author François Marcelli More articles by this author Eric Huyghe More articles by this author Jean-Marie Ferriere More articles by this author Ludovic Ferretti More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...