Abnormal testis at US in patients after orchiectomy for testicular neoplasm

PURPOSE: To categorize ultrasonographic (US) intratesticular abnormalities in patients after orchiectomy for testicular neoplasm and to correlate US, clinical, and histopathologic findings. MATERIALS AND METHODS: Two hundred thirty-five testicular US examinations w ere performed in 171 patients who previously underwent orchiectomy for test icular neoplasm. Abnormalities were identified in 28 patients. The abnormal ities were described as masses, heterogeneous changes, or macrocalcificatio n. US findings were correlated with histopathologic findings in specimens o btained at surgery in 18 patients; follow-up to determine clinical outcome was obtained from the review of medical records in the remaining 10 patient s. RESULTS: Testicular US revealed intratesticular mass in 15, heterogeneous c hanges in 11, and macrocalcification in two patients. Eighteen patients had histopathologic correlation; 13 had testicular cancer. At US, 10 of the 15 (67%) patients with a mass and only three of the 11 (27%) with heterogeneo us changes had cancer. All 10 patients without surgical correlation had cli nical follow-up of 2 1/2-7 years (mean, 3.95 years), with no evidence of di sease. CONCLUSION: Intratesticular mass always is a concern, and heterogeneous cha nges are less worrisome, but in ail patients, rigorous follow-up is recomme nded to rule out malignancy.