Leonhartsberger Nicolai, Pichler Renate, Stoehr Brigitte, Horninger Wolfgang, Steiner Hannes
Department of Urology, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria,
World J Urol. 2014 Aug;32(4):1087-91. doi: 10.1007/s00345-013-1174-4. Epub 2013 Oct 4.
Ablation of the testis has been the reference standard for malignant and benign testicular tumors in the past. Nowadays, an organ-sparing surgery (OSS) can be attempted in special cases. Removal of a testis for a benign lesion should be avoided. In this retrospective survey, we analyze the results and long-term follow-up of OSS in benign testicular tumors.
Charts of all patients that underwent OSS because of a benign testicular tumor between 1999 and 2011 at our department were searched and the data from patients were collected. Before surgery, all patients underwent ultrasound (US) and complete staging. Surgery was performed under US or palpation guidance. Frozen-section examination of the tumor and tumor bed biopsies was obtained. All patients underwent postoperative follow-up. We retrospectively reviewed surgical technique, histology, epidemiology, and outcome in all patients.
In the study period, 40 benign testicular tumors were surgically removed in 37 consecutive patients. Definitive histology did not report of any malignant histopathologic features in all patients. All patients are free of disease after a mean follow-up of 63 months (range 10-120). During this period, two patients developed a second leydig cell tumor (LCT) on the contralateral side; another patient had a second LCT within the same testicle, but on the opposite pole. All patients underwent a subsequent organ-sparing tumor resection.
An overtreatment for benign testicular tumors should be avoided. Our initial results indicate that OSS in benign tumors is a safe, feasible treatment for patients.
过去，睾丸切除一直是恶性和良性睾丸肿瘤的参考标准。如今，在特殊情况下可尝试保留器官手术（OSS）。应避免因良性病变切除睾丸。在这项回顾性研究中，我们分析了良性睾丸肿瘤OSS的结果及长期随访情况。
检索了1999年至2011年间在我科因良性睾丸肿瘤接受OSS治疗的所有患者的病历，并收集患者数据。术前，所有患者均接受超声（US）检查及全面分期。手术在超声或触诊引导下进行。获取肿瘤的冰冻切片检查及肿瘤床活检。所有患者均接受术后随访。我们回顾性分析了所有患者的手术技术、组织学、流行病学及结果。
在研究期间，37例连续患者共手术切除40个良性睾丸肿瘤。所有患者的最终组织学检查均未报告任何恶性组织病理学特征。平均随访63个月（范围10 - 120个月）后，所有患者均无疾病。在此期间，2例患者对侧出现第二个睾丸间质细胞瘤（LCT）；另1例患者在同一睾丸的对侧极出现第二个LCT。所有患者随后均接受了保留器官的肿瘤切除术。
应避免对良性睾丸肿瘤进行过度治疗。我们的初步结果表明，OSS对良性肿瘤患者是一种安全、可行的治疗方法。
