The rate of histologically benign testis following radical orchidectomy
BAUS ePoster online library. Berridge C. Jun 25, 2019; 265257; CU-4
Mr. Christopher Berridge
Mr. Christopher Berridge
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The standard of care for a man with a suspected malignant testicular tumour and normal contralateral testis is radical orchidectomy, testicular tumour markers and CT staging. EAU Guidance encourages obtaining pre-operative staging but this carries the risk of imaging patients with benign disease and therefore delivering unnecessary radiation. We sought to find the number of patients with benign histology following MDT decision for radical orchidectomy for testicular cancer in order to justify changing our local protocol to adopt early CT staging. One previous study established benign histology in 8% of radical orchidectomies.

Any patients discussed at MDT regarding testicular tumours with histology following radical orchidectomy between 1/1/2016 and 31/12/2018 were reviewed. This information was obtained from MDT records.

From 127 patients records that were reviewed, 113 were included. Seven patients had benign histology following radical orchidectomy (6.2%). 93.8% were malignant testicular tumours (n=106), half of which were pure seminomas (n=57), with Germ cell tumours overall representing 83% (n=94). The histological results of the remaining tumours were Lymphoma (n=4), Sertoli cell (n=3), Leydig cell (n=2), Sarcoma (n=2) and Schwannoma (n=1). The benign histology included one adenomatoid tumour and the remainder showed features of either infarction or inflammation.

It is reassuring that just 6.2% of patients had benign histology, less than in available literature. This supports organising pre-operative imaging given the limited number exposed to ionising radiation with benign disease.

Main Article
Radical orchidectomy is the standard of care for suspected testicular malignancy, in combination with tumour marker assessment and staging imaging (1). Following a clinical suspicion of a testicular lesion, supported by history and examination, an ultrasound examination of t
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