@article{3195171,
    title = "The role of radiological surveillance in the conservative management of
incidental small testicular masses: A systematic review",
    author = "Brown, Dominic and Tsampoukas, Georgios and Popov, Elenko Petkov and and Aldin, Zaid and Moussa, Mohamad and Papatsoris, Athanasios and Buchholz, and Noor N. P.",
    journal = "Arab Journal of Urology",
    year = "2021",
    volume = "19",
    number = "2",
    pages = "179-185",
    publisher = "TAYLOR & FRANCIS LTD LONDON",
    issn = "2090-598X",
    doi = "10.1080/2090598X.2021.1885949",
    keywords = "Testicular tumour; impalpable testicular mass; incidental testicular
mass; radiological surveillance",
    abstract = "Objective: The increasing use of scrotal ultrasonography (US) for
non-cancerous indications has led to greater detection of incidental,
small testicular masses. Operative intervention is currently the
mainstay of treatment for all testicular tumours; however, despite the
low malignant potential of small, incidental masses, little is known
about conservative management using radiological surveillance.
Methods: A systematic review using the Preferred Reporting Items for
Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted
and studies meeting the inclusion criteria were reviewed for patient
outcomes.
Results: A total of 293 patients across six studies underwent
radiological surveillance for an incidental small testicular mass.
Infertility was the main indication for investigation and all studies
used US as the surveillance modality. A total of 37 patients (12.6%)
underwent surgical exploration during follow-up, with only 10 (3.4%)
found to have malignant disease at histology.
Conclusions: Radiological surveillance of incidental small testicular
masses is safe when used for select patient groups due to the high
probability of benign disease, although optimal patient selection
criteria and a well-defined protocol are lacking. This approach could be
considered in patients with incidental, impalpable testicular masses of
<= 5 mm in diameter displaying no significant size increase or internal
vascularity on US and with negative tumour markers, as the probability
of malignancy in these patients is low."
}