Abnormal Testis at US in Patients after Orchiectomy for Testicular Neoplasm

http://radiology.rsna.org/content/215/2/432.full

Ariadne M. Bach, MD ; Joel Sheinfeld, MD ; Lucy E. Hann, MD

1 From the Departments of Radiology (A.M.B., L.E.H.) and Urology (J.S.), Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021. From the 1998 RSNA scientific assembly. Received November 9, 1998; revision requested January 11, 1999; final revision received September 3; accepted September 15. Address correspondence to A.M.B. (e-mail: bacha@mskcc.org).

PURPOSE: To categorize ultrasonographic (US) intratesticular abnormalities in patients after orchiectomy for testicular neoplasm and to correlate US, clinical, and histopathologic findings.

MATERIALS AND METHODS: Two hundred thirty-five testicular US examinations were performed in 171 patients who previously underwent orchiectomy for testicular neoplasm. Abnormalities were identified in 28 patients. The abnormalities were described as masses, heterogeneous changes, or macrocalcification. US findings were correlated with histopathologic findings in specimens obtained at surgery in 18 patients; follow-up to determine clinical outcome was obtained from the review of medical records in the remaining 10 patients.

RESULTS: Testicular US revealed intratesticular mass in 15, heterogeneous changes in 11, and macrocalcification in two patients. Eighteen patients had histopathologic correlation; 13 had testicular cancer. At US, 10 of the 15 (67%) patients with a mass and only three of the 11 (27%) with heterogeneous changes had cancer. All 10 patients without surgical correlation had clinical follow-up of 2½–7 years (mean, 3.95 years), with no evidence of disease.

CONCLUSION: Intratesticular mass always is a concern, and heterogeneous changes are less worrisome, but in all patients, rigorous follow-up is recommended to rule out malignancy.