Small testicular mass common in infertile males
Small testicular masses do not appear to be rare in the infertile male population, with most of the masses exhibiting no significant growth with long-term evaluation and can be safely monitored with close follow-up, according to a study.
Researchers performed a retrospective review of prospectively-collected databases to identify male infertility patients with incidental small testicular masses (hypoechoic lesions <10 mm) on scrotal ultrasonography. Close surveillance with interval imaging and office follow-up were offered to all patients.
Predictors of underlying malignancy were examined by comparing patient and imaging characteristics between surveillance and surgical groups with additional comparisons between benign and malignant pathologies.
In a cohort of 4,088 men completing a scrotal ultrasound for male infertility evaluation, 120 (2.9 percent) had a subcentimeter testicular mass.
Of the men with testicular masses, 18 proceeded with extirpative surgery while 102 remained on surveillance during an average follow-up of 1.30 years. Based on data from patients with at least 1 month of follow-up, the mean lesion growth rate was -0.01 mm/yr.
Commonly reported reasons for undergoing surgery included testicular exploration for infertility, mass growth, positive tumour markers, history of testis cancer, concerning imaging characteristics and patient choice. Six of the 18 patients undergoing surgery had a malignancy, all of which were seminoma, >5 mm on initial imaging and demonstrated vascularity. However, the size and vascularity of the malignant lesions did not significantly differ from benign lesions on final pathology.
None of the patients in the cohort exhibited advanced or recurrent disease.