Radikal orşiektomi yapılan hastalarda saptanan benign testis kitleleri ve özellikleri

Amaç: Radikal orşiektomi yapılan hastalarda saptanan benign testiküler patolojilerin oranını ortaya koymayı ve testis kitlelerinde benign/malign ayrımında klinisyenlere yol gösterici olmayı amaçladık.Gereç ve Yöntem: 2008-2018 yılları arasında radikal orşiektomi operasyonu geçiren hastaların verileri retrospektif olarak incelendi. İncelen parametreler hastaların demografik bilgileri, operasyon öncesi serum tümör belirteçleri, skrotal görüntüleme yöntemleri sonuçları ve final patoloji sonuçlarından oluşmakta idi.Bulgular: Çalışmaya toplam 171 hasta dahil edildi. Hastaların ortalama yaşı 35.4 ± 13.6 yıl idi. Final patoloji raporuna göre 29 hastada (%17) benign testiküler patoloji saptanırken 142 hastada (%83) malignite saptanmış idi. Benign patolojiye sahip olan grubun işlem öncesi AFP, β-HCG ve LDH değerleri malign patolojiye sahip olan gruba göre anlamlı olarak düşük idi: 2.03± 1.8 IU/mL, 0.32± 0.44 mIU/mL , 157.3± 163.5 U/L ‘e karşın 335.5 ±1490.7 IU/ mL, 4045.9± 24444.7 mIU/mL, 423 ±1089.2 U/L (tüm değişkenler için p< .001). Benign patolojiye sahip olan grubun preoperatif USG in- celemesinde testisteki kitle boyutu 3.02±2.2 cm iken malign grubunki 4.9±2.5 cm idi (p=0.006).Sonuç: Küçük, palpe edilemeyen, serum tümör belirteçlerinde yükselmeye neden olmayan ve testis tümörünün sık görüldüğü 15-34 yaş aralığı dışında kalan hastalardaki testiküler lezyonların yüksek oranda benign olabileceği göz önünde bulundurulmalı ve gerekirse testis koruyucu cerrahi planlanmalıdır.

Anahtar Kelimeler:

testis tümörü, orşiektomi, testis koruyucu cerrahi

Benign testicular masses and their characteristics determined in patients who underwent radical orchiectomy

Objective: We aimed to reveal the rate of benign testicular pathologies detected in patients who underwent radical orchiectomy and to guide clinicians in the differentiation of benign / malignant testicular masses.Materials and Methods: The data of patients who underwent radical orchiectomy operation between 2008-2018 were retrospectively reviewed. The parameters examined were demographic information of the patients, preoperative serum tumor markers, scrotal imaging results and final pathology results.Results: A total of 171 patients were included in the study. The mean age of the patients was 35.4 ± 13.6 years. According to the final pathology report, benign testicular pathology was found in 29 patients (17%) and malignancy was found in 142 patients (83%). The preoperative AFP, β-HCG and LDH values of the group with benign pathology were significantly lower than the group with malignant pathology: 2.03 ± 1.8 IU / mL, 0.32 ± 0.44 mIU / mL, and 157.3 ± 163.5 U / L compared to 335.5 ± 1490.7 IU / mL, 4045.9 ± 24444.7 mIU / mL, 423 ± 1089.2 U / L (p < .001 for all variables). In the preoperative USG examination of the group with benign pathology, the size of the mass in the testis was 3.02 ± 2.2 cm while the malignant group was 4.9 ± 2.5 cm (p = 0.006).Conclusion: It is important to consider that small, non palpable testicular lesions don’t cause elevated serum tumor markers in patients outside the 15-34 age range, in which testicular tumors are frequent, may be highly benign and testis preserving surgery should be planned if necessary.

Keywords:

testicular tumor, orchiectomy, testis sparing surgery,

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