Testis-sparing surgery for benign and malignant testicular tumours

We report the technique of testis-sparing surgery in three young men with testicular tumours, two of which were found to be benign (Leydig cell tumour and benign teratoma) and one malignant (seminoma) on frozen section and final pathological evaluation. The principles of clamping the spermatic cord with a soft bowel clamp, testicular cooling with ice slush, tumour enucleation with clear margins, meticulous haemostasis and frozen section analysis were followed. Testicular preservation was successful in the patients with benign disease. The patient with seminoma was found to have a separate nodule of invasive, poorly differentiated seminoma in the residual testis, which had not been detected on preoperative ultrasound scanning. As a result he was converted to radical orchidectomy.