Alternative to Radical Orchietomy???

[melrose]

I have a nonpalpable intratesticular tumor/shadow. I have been told that I can have an operation called "ultrasound guided needle localization and microsurgical exploration for incidental nonpalpable testicular tumors".
The surgery is just like a Radical Orchietomy but the testi is brought thru the incision the doctor clamps off the blood supply, puts the testi on ice, takes out the entire tumor and sends a frozen section to pathology to find out if its malignant. If it is malignant the doctor completes the Radical orchietomy if it is not malignant the doctor puts the testi back in place.
I have not read a lot about this practice and I don't think a lot of doctors do this. My concern was for contamination and spreading if the cells are cancerous, the doctor says this is not possible, he cleanses the entire area and the blood supply is cutoff.

Has anyone heard of this type of operation????? The doctor I'm going to is well known with a leading NYC hospital so i don't question his knowledge, just wonder why most Testicular cancer web sites dont talk about this procedure. i have read that 80% of nonpalpable tumors are benign. Why lose a testicle if you don't have to.

Thanks for any response and i hope this may be helpful to others

[Don]

I think is there was even a slight chance of the growth being cancer or having the possibility of becoming cancer I would want it out of there ASAP. Life is pretty much normal with just one!!!!!!! I would rather have one testicle and know that my chances of having T/C are slim to none!!! Good Luck with whatever you choose!!!! DON

[melrose]

The growth will come out in its entirety. It will then be analyzed by a pathologist while I'm still in the operating room. if it is determined to be malignant or if he is still unsure he will complete the orchiectomy by removing the testi and cords. If it turns out to benign, (in fact there are not even calling it a tumor at this point, being it was an incidental finding while I was having a ct scan due to kidney stone) there would be no reason not to put it back in. I have no other signs of TC, No mass which can be felt, negative tumor markers and I'm 43 years old.

[Scott]

You do sometimes hear about this. The possibility of a frozen section biopsy shows up in the TCRC's list of questions to ask your doctor about the orchiectomy.

[melrose]

My doctor says in fact its not a biopsy, but he is able to remove(excise) whatever he finds(they are not sure what it is, might just be a hematoma from an old injury) test it by frozen section and proceed accordingly.
I guess the big difference for me is that this was an incidental finding and there is no mass that can be felt. If the mass was palpable(easily felt) I would opt for I/O, being that most palpable masses turn out to be malignant.
thank you for your comments.

[Scott]

It sounds like a biopsy to me, at least according to this definition.

Anyway, I guess that's beside the point. Assuming there's reason to be suspicious of what you found but not enough to be fairly certain yet that it's a cancerous tumor, there's nothing to lose and obviously something to gain from doing an excisional biopsy before completing the orchiectomy.