From the Guidelines
Adenomatoid tumors of the testicle are benign growths that should be treated with surgical excision, prioritizing partial orchiectomy to preserve healthy testicular tissue, as they have an excellent prognosis with no risk of recurrence or malignant transformation. When considering the management of adenomatoid tumors, it's essential to focus on the most recent and highest quality evidence available, although the provided study 1 primarily discusses testicular seminoma and non-seminoma, emphasizing the importance of early detection and treatment in testicular cancers. Key points to consider in the management of adenomatoid tumors include:
- They are the most common type of paratesticular tumor, typically found in men between 30-50 years old.
- Surgical excision is the treatment of choice, with partial orchiectomy being preferred when possible to preserve testicular function.
- The prognosis after removal is excellent, with no reported risk of recurrence or malignant transformation.
- Regular testicular self-examinations are crucial for early detection of any testicular abnormalities, including adenomatoid tumors. Given the benign nature of adenomatoid tumors and their excellent prognosis after surgical removal, the primary goal should be to remove the tumor while preserving as much healthy testicular tissue as possible, thus minimizing potential impacts on fertility and hormonal function. In clinical practice, while the study 1 does not directly address adenomatoid tumors, its emphasis on the importance of early detection and appropriate management of testicular masses indirectly supports the approach to adenomatoid tumors, highlighting the need for prompt evaluation and treatment of any testicular abnormalities.
From the Research
Adenomatoid Tumor of the Testicle
- Adenomatoid tumors are rare benign neoplasms thought to be of mesothelial origin 2
- They can arise from the epididymis, spermatic cord, testicular tunica, ejaculatory ducts, prostate, and suprarenal recess 2
- In the testis, adenomatoid tumors are extremely rare and can be misdiagnosed as malignant tumors, leading to unnecessary radical resection 3, 4
Clinical Features and Diagnosis
- The mean age of patients with testicular adenomatoid tumors is around 42-44 years 3, 4
- Serum levels of tumor markers, such as human choriogenic gonadotropin (hCG) and alpha-fetoprotein (AFP), are typically within normal limits 3, 4
- Ultrasonography can reveal a hyperechoic mass, but the diagnosis is often made by frozen section examination during surgery 3, 4
Treatment and Management
- The recommended treatment for adenomatoid tumors is local excision or partial resection of the testis via the inguinal approach, with preservation of the organ whenever possible 3, 2, 4
- Testicular sparing surgery is a safe option for small testicular nodules, but requires a standardized diagnostic-therapeutic pathway 5
- Frozen section examination should be performed with the help of an experienced pathologist to confirm the diagnosis and guide treatment decisions 6