|ECR 2015 / C-2542|
|Contrast-enhanced ultrasound in the differential diagnosis of small testicular masses|
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Aims and objectives
Small testicular masses (STMs), defined as non palpable, < 25mm diameter mass , are a growing problem, because many cases may be benign at final histology. Testicular cancer represents between 1% and 1.5% of male neoplasms and 5% of urological tumours in general, with 3-10 new cases occurring per 100,000 males/per year in Western countries [2-4]. Malignant germ cell neoplasms represent most of the palpable symptomatic testicular masses. Therefore, radical orchiectomy has been the standard of care for testicular masses. However the widespread use of high-frequency ultrasonography has led to an increasing number of incidentally STM detected, most of which have been shown to be benign . Therefore Testis-Sparing Surgery (TSS) has been proposed as alternative to radical orchifunicolectomy .
The preoperative differential diagnosis of non-palpable testicular lesions by imaging methods (especially by ultrasound, US) has become crucial because it allows, in case of negativity of biochemical tumor markers, a conservative surgical approach (TSS).
Although Conventional ultrasonography has high sensibility (96.6%) for detection of small intra-testicular lesions, sonographic appearance of testicular lesions may be various and not specific and the technique cannot differentiate benign from malignant lesions .
Some advanced ultrasonography techniques, like contrast-enhanced ultrasonography (CEUS) have been proposed to increase diagnostic accuracy in characterization of testicular lesions :
CEUS permits visualization of the microcirculation identifying avascular lesions without malignant potential . This technique allows the study of enhancement pattern which could further assist in characterising lesions.
The aim of this study was to evaluate the role of Contrast Enhanced Ultrasound (CEUS) in the characterization of small testicular masses (STMs).
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