Also available in: Español
Rev Mex Urol. 2018 March-April;78(2):123-128. DOI: https://doi.org/10.24245/revmexurol.v78i2.1913
Axel Alberto Cayetano-Alcaraz,1 Mirha Halilovic,1 Natalia Olavarria-Sayavedra,1 Christian Aníbal Quiñones-Capistrán,1 Ricardo Arceo-Olaiz,2 Ricardo Alonso Castillejos-Molina1
1 Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Ciudad de México.
2 Hospital Ángeles Pedregal, Ciudad de México.
BACKGROUND: Most testicular lesions are detected at the early stage and up to 10-20% of them are benign. Frozen section examination (FSE) has proven to be reliable for evaluating testicular lesions. The diagnosis of benign histology can prevent unnecessary radical orchiectomy and its complications.
OBJECTIVE: To evaluate the diagnostic accuracy of FSE of equivocal malignant testicular masses (EMTMs), as well as the short and long-term complications associated with that procedure.
MATERIALS AND METHODS: A retrospective study was conducted between 2005 and 2015 at a tertiary care center on patients that underwent testicular exploration through FSE due to EMTM. Diagnostic accuracy measures were obtained, and the short and long-term complications were recorded. The study design was carried out following the STARD (Standards for Reporting of Diagnostic Accuracy) recommendations.
RESULTS: Twenty-three patients were included in the study. Median follow-up was 10 months (interquartile range: 60). A total of 73.9 of the lesions were benign and 26.1% were malignant. There were no diagnostic changes in relation to the FSE and definitive pathology reports. Diagnostic accuracy measures were 100%. The degree of concordance between the FSE and definitive malignancy reports was statistically significant (κ = 1.0, p <0.05). As a result of the benign FSE report, 12 radical orchiectomies (70.6%) were prevented. Three patients (12.5%) had grade I complications. In the long term, 2 patients presented with testicular atrophy. No malignant formations were observed during follow-up in the patients that did not undergo radical orchiectomy as a result of the benign FSE report.
CONCLUSION: Testicular frozen section examination is a reliable technique in equivocal malignant lesion management and is associated with low-grade complications.
KEYWORDS: Frozen Sections; Diagnostic accuracy; Testicular neoplasms; Retrospective studies; Testis pathology.
Ricardo Alonso Castillejos Molina