RSNA 2007 

Abstract Archives of the RSNA, 2007


LL-GU2185-R04

Ultrasound-guided Core Needle Biopsy of the Testis

Scientific Posters

Presented on November 29, 2007
Presented as part of LL-GU-R: Genitourinary -

Participants

Edmund Soh MBBS, Presenter: Nothing to Disclose
Michael V. Williams, Abstract Co-Author: Nothing to Disclose
John W. Grant MD, Abstract Co-Author: Nothing to Disclose
Laurence Berman, Abstract Co-Author: Nothing to Disclose

PURPOSE

This study describes our experience with ultrasound(US)-guided core-needle biopsy of the testis in the setting of equivocal primary testicular malignancy.

METHOD AND MATERIALS

11 patients (age range, 28-62 years) underwent an US-guided testicular biopsy between April 2003 and October 2006, performed with a freehand technique and direct US guidance. 9 patients had local anesthesia to the skin and testis; 2 patients had general anesthesia for additional procedures (one contralateral orchiectomy; the other, drainage of hydrocele). A 16- or 18-gauge spring-loaded core biopsy needle (Temno; UK Medical, Sheffield) was used.

RESULTS

Patients underwent biopsies in 4 main clinical scenarios: 1) lesions with equivocal malignant features on US, 2) a discrepancy between radiological diagnosis and clinical findings, 3) a suspected malignant disease process where orchiectomy may be unnecessary e.g. lymphoma, 4) atrophic testes, where it is frequently difficult to differentiate malignancy from the heterogeneous background gray-scale echo pattern. 6 patients had benign histology on their core-needle samples. No surgical intervention was indicated in 5 of these patients and follow-up was uneventful. The 6th of the non-malignant biopsy group underwent orchiectomy due to persistent clinical concern but no malignancy was found in the resected testis. Of the 5 malignant core biopsies, 2 patients had primary testicular tumors and both are doing well following orchiectomy and chemotherapy. 3 patients had hematological malignancies and underwent successful chemotherapy without orchiectomy. No complications were encountered. All biopsies were well tolerated and were considered, on the basis of resection histology or interval follow-up, to be representative.

CONCLUSION

US-guided core-needle biopsy under local anesthesia is a safe, low-cost, well-tolerated procedure. In the setting of equivocal primary testicular malignancy the technique may prevent orchiectomy for non-malignant disease or malignancy requiring chemotherapy rather than orchiectomy.

CLINICAL RELEVANCE/APPLICATION

In the setting of equivocal primary testicular malignancy, US-guided core-needle biopsy of the testis is of benefit in selected clinical situations and may avoid the need for orchiectomy.

Cite This Abstract

Soh, E, Williams, M, Grant, J, Berman, L, Ultrasound-guided Core Needle Biopsy of the Testis.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5000983.html