Incidental testicular tumors in infertile men

Abstract 

Objective

To characterize the population of infertile men with an incidental finding of testicular tumor diagnosed during infertility work-up and to describe their unique presentation and pathological findings.

Design

Retrospective study of 11 men in whom a testicular tumor was incidentally diagnosed during evaluation for infertility out of 150 patients who underwent orchiectomy over a 10-year period (1992 to 2002).

Setting

University-affiliated urologic referral center.

Patient(s)

Infertile men with an incidental testicular mass who underwent radical orchiectomy.

Intervention(s)

Description of patient characteristics: age at diagnosis, presentation, history of undescended testis, and type of infertility.

Main outcome measure(s)

Tumor size and location and pathological diagnosis.

Result(s)

Eleven patients met the study's inclusion criteria, 11 tumors were identified and characterized. The tumors were usually small, centrally located and nonpalpable. Histologically, six were malignant germ-cell tumors and three were Leydig-cell tumors; two patients had no histologic evidence of tumor. All patients with a history of undescended testis had malignant germ-cell tumors.

Conclusion(s)

The use of trans-scrotal sonography enables early diagnosis of small nonpalpable tumors. A history of an undescended testis may necessitate a more aggressive approach, as these patients are at increased risk for testis cancer. Further studies are warranted to establish the yield of routine sonographic screening of infertile men and their specific management.

Keywords:  Testis cancer, infertility, testicular sonography, incidental testicular mass, Leydig-cell tumor