Intraoperative injection of (99mm)Tc- nanocolloid for localization of nonpalpable intratesticular tumours in organ-sparing surgery

Abstract

Objective: Radical orchidectomy is the standard treatment for malignant testis tumours. Radical orchidectomy results in androgen deprivation, infertility and impaired psychological well-being, especially in synchronous bilateral tumours, metachronous contralateral tumours or tumour in a solitary testis. According to the European Association of Urology Guidelines, if pre-operative testosterone level is normal and the tumour volume is less than 30% of the testicular volume, organ preserving surgery can be performed. For nonpalpable tumours, organ-sparing surgery needs a precise intraoperative localization with high-frequency ultrasound, especially for nonpalpable tumours.

Matherial and methods: We report two cases of nonpalpable intratesticular tumours successfully localised using (99mm)Tc nanocolloid injected with intraoperative US and detected with a γ-ray detection probe.

Conclusions: This method is easily reproducible and safe for the patient. This technique could guarantee complete excision of the tumour, especially if the mass is poorly delimited.

Keywords: Ecografía testicular intraoperatoria; Intraoperative testicular ultrasound; Intratesticular; No palpable; Nonpalpable; Organ-sparing surgery; Orquiectomía parcial; Tecnecio-99 metaestable; Tecnecium-99mm; Tumor; Tumour.