2018, Number 2
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Rev Mex Urol 2018; 78 (2)
Diagnostic accuracy and complications of frozen section examination of equivocal malignant testicular masses
Cayetano-Alcaraz AA, Halilovic M, Olavarria-Sayavedra N, Quiñones-Capistrán CA, Arceo-Olaiz R, Castillejos-Molina RA
Language: English
References: 15
Page: 128-134
PDF size: 405.41 Kb.
ABSTRACT
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 longterm
complications associated with that procedure.
Material and Method: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.
Conclusions: Testicular frozen section examination is a reliable
technique in equivocal malignant lesion management and is associated
with low-grade complications.
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