Background:

Most testicular lesions are detected at the early stage and up to 10-20% of them are benign. Frozen section examination (FSE) has proven to be reliable for evaluating testicular lesions. The diagnosis of benign histology can prevent unnecessary radical orchiectomy and its complications.

Objective:

To evaluate the diagnostic accuracy of FSE of equivocal malignant testicular masses (EMTMs), as well as the short and long-term complications associated with that procedure.

Materials and methods:

A retrospective study was conducted between 2005 and 2015 at a tertiary care center on patients that underwent testicular exploration through FSE due to EMTM. Diagnostic accuracy measures were obtained, and the short and long-term complications were recorded. The study design was carried out following the STARD (Standards for Reporting of Diagnostic Accuracy) recommendations.

Results:

Twenty-three patients were included in the study. Median follow-up was 10 months (interquartile range: 60). A total of 73.9% of the lesions were benign and 26.1% were malignant. There were no diagnostic changes in relation to the FSE and definitive pathology reports. Diagnostic accuracy measures were 100%. The degree of concordance between the FSE and definitive malignancy reports was statistically significant (κ = 1.0, p < 0.05). As a result of the benign FSE report, 12 radical orchiectomies (70.6%) were prevented. Three patients (12.5%) had grade I complications. In the long term, 2 patients presented with testicular atrophy. No malignant formations were observed during follow-up in the patients that did not undergo radical orchiectomy as a result of the benign FSE report.

Conclusion:

Testicular frozen section examination is a reliable technique in equivocal malignant lesion management and is associated with low-grade complications.

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