The incidental discovery of small masses in the testicles of young men is becoming an increasing clinical dilemma. We are learning that the malignancy rate in masses ≤ 2 cm is much lower than traditionally thought and could be as low as 13% to 21%. The challenge remains in identifying which of these patients harbor malignant tumors that need to be treated, and benign lesions that could be safely surveilled. The aim of this narrative review is to discuss the current scientific evidence, diagnostic work-up, and treatment strategies for small testicular masses. We also discuss selection criteria, follow-up schedules and triggers for intervention for the surveillance of these small testis masses. Furthermore, we give a set of recommendations for assessing and treating these patients, based on the available literature and our experience at a dedicated testicular cancer clinic.
Urologic oncology. 2023 Mar 27 [Epub ahead of print]
Julian Chavarriaga, Robert Hamilton
Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, Toronto, Ontario, Canada. Electronic address: ., Division of Urology, Department of Surgery, Princess Margaret Cancer Centre, Toronto, Ontario, Canada.