Is biopsy needed for many solid nodules on testicular USG?

Question

Hi doctor,

I have had an ultrasound on my testicles and found multiple solid nodules or lumps and lesions in both testicles. He strongly suspects germ cell tumors. I have had blood tests done, and tumor markers and everything else is normal. I will be seeing a urologist in about two weeks. Do I have cancer? Can my testicles be biopsied without losing them?

Kindly help.

Answer 1

Hi,

Welcome to icliniq.com.

Any testicular mass is treated as cancer unless proven otherwise. That is why it is advised to evaluate the lesions found by patient or ultrasound by surgical removal and detailed pathological examination. Whereas for most other sites, the biopsy is possible. The biopsy is not recommended for testicular lesions as there is a very high risk of either seeding to the scrotal skin and changing the lymphatic drainage of the testis. In your cases as well, the biopsy is not an option, unless a lymphoma or leukemia is suspected. It is unlikely at your age unless you had it in the past. The option is further evaluation of these lesions on MRI imaging as suggested by your radiologist. That can clarify the matter a bit more. If there is still confusion, then very close short-term follow-up can be done. If these are still suspicious for cancer on MRI, then removal and pathological examination are the recommended protocol. Please talk to your urologist about it.

Thank you.