scholarly journals Frozen-section examination in the management of paediatric testicular lesions

2021 ◽  
Author(s):  
E. O’Connor ◽  
C. Roy ◽  
S. Annavarapu ◽  
H. O. Gabra
Keyword(s):  
Frozen Section ◽  
Pathological Examination ◽  
Benign Lesions ◽  
Single Centre ◽  
Frozen Section Examination ◽  
Paediatric Patients ◽  
Benign Pathology ◽  
Age At Surgery ◽  
Testicular Lesions ◽  
Paediatric Practice

Abstract Purpose Paediatric testicular and para-testicular lesions have traditionally been managed according to adult protocols. Testis-sparing surgery (TSS) has gained popularity as it has become apparent benign lesions predominate in childhood. Frozen-section examination (FSE) for intra-operative diagnosis has been extensively utilised in adults, though its use in paediatric practice remains limited. We reviewed our experience of FSE in paediatric patients with an aim to identify the utility and efficacy of this tool in the management of testicular and para-testicular pathology. Methods A retrospective, single-centre review of paediatric patients who underwent intra-operative FSE for a range of testicular and para-testicular lesions was performed. FSE results were compared to final pathology. TSS was performed if appropriate, and was utilised in adolescent patients, and in lesions with a diameter greater than 20 mm. Results Nine males underwent FSE from 2013 to 2020. Median age at surgery was 9 years (range 1–15). Eight (89%) patients had benign pathology. FSE result correlated with the final pathological examination in 100% of cases. FSE facilitated TSS in 7/9 cases. Conclusion FSE has 100% diagnostic accuracy for paediatric testicular and para-testicular pathology. We would recommend all lesions be evaluated by FSE to guide intra-operative decision making and facilitate TSS in appropriate cases.

The role of frozen section examination (FSE) during inguinal exploration in 1052 patients with inconclusive testicular lesions

2018 ◽  
Vol 17 (14) ◽  
pp. e3005
Author(s):  
C. Fankhauser ◽  
L. Roth ◽  
N. Grossmann ◽  
B. Kranzbühler ◽  
D. Eberli ◽  
...  
Keyword(s):  
Frozen Section ◽  
Frozen Section Examination ◽  
Testicular Lesions

Testis Sparing Microsurgery

2006 ◽  
Vol 73 (2) ◽  
pp. 237-241
Author(s):  
L. Rolle ◽  
M. Timpano ◽  
P. Destefanis ◽  
A. Bosio ◽  
C. Fiori ◽  
...  
Keyword(s):  
Frozen Section ◽  
Benign Lesion ◽  
Reliable Technique ◽  
Frozen Section Examination ◽  
Scrotal Ultrasound ◽  
Mean Size ◽  
Testicular Lesions ◽  
Radical Orchiectomy ◽  
Bilateral Lesions

The unexpected detection of non palpable hypoechoic testicular lesions has become more frequent thanks to the increased use of trans-scrotal ultrasound (US): patients are often asymptomatic and the objective examination reveals no palpable masses. The different diagnostic, therapeutic approaches vary from radical orchifunicolectomy to simple US follow-up, although the guidelines on the management of these lesions are not defined, yet. The article shows our series of patients with hypoechoic testicular lesions who underwent surgical exploration, with the aid of the operating microscope and histologic test. Materials and Methods 6 patients in total underwent microsurgical exploration of non palpable hypoechoic testicular lesions, from April 2003 to December 2004. Results 4 out of the 6 cases were a left-sided testicular lesion, whereas the 2 remaining cases revealed a right-sided lesion [hypoechoic areas mean size = 3.9 mm (range 2.5 – 16)]. The lesions in all patients could be easily identified and successfully excised thanks to the microsurgical technique. The intraoperative frozen section examination (FSE) showed a benign lesion in 5 cases and an intratubular germ cell neoplasia (ITGCN) in one. Patient with ITGCN underwent radical orchiectomy. The final histological analysis confirmed the frozen section examination report for all the 6 cases. Patients were clinically and ultrasonographically evaluated with a mean follow-up of 15 months. No complication occurred. Conclusion Microsurgical exploration of the testis combined with FSE represents a safe, effective and reliable technique in case of non palpable hypoechoic testicular lesions. This approach leads to significant advantages and should be considered especially in patients with a solitary testis or presenting bilateral lesions, and wishing to father a child.

scholarly journals Testicular sparing surgery in small testis masses: A multinstitutional experience

2016 ◽  
Vol 88 (4) ◽  
pp. 320 ◽  
Author(s):  
Andrea B. Galosi ◽  
Paola Fulvi ◽  
Andrea Fabiani ◽  
Lucilla Servi ◽  
Alessandra Filosa ◽  
...  
Keyword(s):  
Tumor Markers ◽  
Malignant Tumor ◽  
Frozen Section ◽  
Intraoperative Ultrasound ◽  
Testicular Tumor ◽  
Pathological Examination ◽  
Small Lesion ◽  
Benign Lesions ◽  
Tertiary Center ◽  
Small Testis

Introduction: The incidence of benign testicular tumors is increasing in particular in small lesion incidentally found at scrotal ultrasonography. Primary aim of this study was to perform radical surgery in malignant tumor. Secondary aim was to verify the efficacy of the diagnostic-therapeutic pathway recently adopted in management of small masses with testis sparing surgery in benign lesions. Materials and methods: In this multicenter study, we reviewed all patients with single testis lesion less than 15 mm at ultrasound as main diameter. We applied the diagnostic-therapeutic pathway described by Sbrollini et al. (Arch Ital Urol Androl 2014; 86:397) which comprises: 1) testicular tumor markers, 2) repeated scrotal ultrasound at the tertiary center, 3) surgical exploration with inguinal approach, intraoperative ultrasound, and intraoperative pathological examination. Definitive histology was reviewed by a dedicated uro-pathologist. Results: Twenty-eight patients completed this clinical flowchart. The mean lesion size was 9.3 mm (range 2.5-15). Testicular tumor markers were normal except in a case. Intraoperative ultrasound was necessary in 8/28 cases. We treated 11/28 (39.3%) with immediate radical orchiectomy and 17/28 (60.7%) with testis-sparing surgery. Definitive pathological results were: malignant tumor in 6 cases (seminoma), benign tumor in 10 cases (5 Leydig tumors, 2 Sertoli tumors, 1 epidermoid cyst, 1 adenomatoid tumor, 1 angiofibroma), benign disease in 11 (8 inflammation with haemorragic infiltration, 2 tubular atrophy, 1 fibrosis), and normal parenchyma in 1 case. We observed a good concordance between frozen section examination and definitive histology. Any malignant tumor was treated conservatively. Any delayed orchiectomy was necessary based on definitive histology. Conclusions: The incidence of benign lesions in 60% of small testis lesions with normal tumor markers makes orchiectomy an overtreatment. Testicular sparing surgery of single testicular nodules below 15 mm is a safe option, but requires a standardized pathway in diagnosis. Our pathway has shown good reliability and security profile to be applied in a multicenter management for small scrotal masses. Our study has shown the reliability of the diagnostic-therapeutic pathway in the management of single testicular masses. The higher incidence of benign lesions in 60% of patients makes often orchiectomy an overtreatment.

MP80-08 DIAGNOSTIC VALUE OF FROZEN SECTION EXAMINATION (FSE) DURING INGUINAL EXPLORATION IN PATIENTS WITH INCONCLUSIVE TESTICULAR LESIONS

2017 ◽  
Vol 197 (4S) ◽  
Author(s):  
Christian Fankhauser ◽  
Joerg Beyer ◽  
Lisa Roth ◽  
Peter-Karl Bode ◽  
Holger Moch ◽  
...  
Keyword(s):  
Frozen Section ◽  
Diagnostic Value ◽  
Frozen Section Examination ◽  
Testicular Lesions

RESEARCH ON VALUE OF INTRAOPERATIVE FROZEN SECTION EXAMINATION OF THE COMMON TUMORS AT HUE UNIVERSITY HOSPITAL

2011 ◽  
pp. 67-73
Author(s):  
Cong Thuan Dang ◽  
Thi Thu Thao Le
Keyword(s):  
Sensitivity And Specificity ◽  
Frozen Section ◽  
Analysis Data ◽  
Poor Quality ◽  
University Hospital ◽  
Frozen Sections ◽  
Intraoperative Frozen Section ◽  
Frozen Section Examination ◽  
Incorrect Diagnosis ◽  
The Common

Background: To evaluate the accuracy and the pitfalls of frozen section examination in diagnosis the common tumors at Hue University Hospital. Materials and method: A retrospective analysis data of 99 consecutive patients from 2007 to 2009 were evaluated and analyzed the major pitfalls. In our 99 patients, 100% cases we compared histological diagnosis on frozen sections with those on paraffin sections. Results: The majority of frozen section examinations were the thyroid lesions 37.4%, breast lesions 25.2%, lymph nodes 16.1%, ovary 9.1% and less common in other diseases (12.1%). The accuracy, sensitivity and specificity of the intraoperative frozen section examination were 93.9%, 89.1% and 98.1% respectively. The main factors causing incorrect diagnosis in frozen section are: Misinterpretation, poor quality of frozen sections, improper sampling in sectioning and difficult to result interpretation. Conclusion: The frozen section analysis of suspect lesions displays good sensitivity and specificity characteristics.

scholarly journals Real-time intraoperative glioma diagnosis using fluorescence imaging and deep convolutional neural networks

2021 ◽  
Author(s):  
Biluo Shen ◽  
Zhe Zhang ◽  
Xiaojing Shi ◽  
Caiguang Cao ◽  
Zeyu Zhang ◽  
...  
Keyword(s):  
Neural Networks ◽  
Real Time ◽  
Fluorescence Imaging ◽  
Convolutional Neural Networks ◽  
Frozen Section ◽  
Fluorescent Imaging ◽  
Pathological Diagnosis ◽  
Pathological Examination ◽  
Deep Convolutional Neural Networks ◽  
Fluorescence Images

Abstract Purpose Surgery is the predominant treatment modality of human glioma but suffers difficulty on clearly identifying tumor boundaries in clinic. Conventional practice involves neurosurgeon’s visual evaluation and intraoperative histological examination of dissected tissues using frozen section, which is time-consuming and complex. The aim of this study was to develop fluorescent imaging coupled with artificial intelligence technique to quickly and accurately determine glioma in real-time during surgery. Methods Glioma patients (N = 23) were enrolled and injected with indocyanine green for fluorescence image–guided surgery. Tissue samples (N = 1874) were harvested from surgery of these patients, and the second near-infrared window (NIR-II, 1000–1700 nm) fluorescence images were obtained. Deep convolutional neural networks (CNNs) combined with NIR-II fluorescence imaging (named as FL-CNN) were explored to automatically provide pathological diagnosis of glioma in situ in real-time during patient surgery. The pathological examination results were used as the gold standard. Results The developed FL-CNN achieved the area under the curve (AUC) of 0.945. Comparing to neurosurgeons’ judgment, with the same level of specificity >80%, FL-CNN achieved a much higher sensitivity (93.8% versus 82.0%, P < 0.001) with zero time overhead. Further experiments demonstrated that FL-CNN corrected >70% of the errors made by neurosurgeons. FL-CNN was also able to rapidly predict grade and Ki-67 level (AUC 0.810 and 0.625) of tumor specimens intraoperatively. Conclusion Our study demonstrates that deep CNNs are better at capturing important information from fluorescence images than surgeons’ evaluation during patient surgery. FL-CNN is highly promising to provide pathological diagnosis intraoperatively and assist neurosurgeons to obtain maximum resection safely. Trial registration ChiCTR ChiCTR2000029402. Registered 29 January 2020, retrospectively registered

scholarly journals A single-centre investigator-blinded randomised parallel group clinical trial to investigate the effect of probiotic strainsStreptococcus salivariusM18 andLactobacillus acidophiluson gingival health of paediatric patients undergoing treatment with fixed orthodontic appliances: study protocol

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e030638 ◽  
Author(s):  
Eleftherios G Kaklamanos ◽  
Rania Nassar ◽  
Sotirios Kalfas ◽  
Manal Al Halabi ◽  
Mawlood Kowash ◽  
...  
Keyword(s):  
Treatment Group ◽  
Oral Hygiene ◽  
Oral Microbiome ◽  
Control Group ◽  
Orthodontic Appliances ◽  
Single Centre ◽  
Paediatric Patients ◽  
Gingival Health ◽  
Parallel Group ◽  
Fixed Orthodontic Appliances

BackgroundThere is limited data on the beneficial effects of probiotics on the gingival health of patients undergoing treatment with fixed orthodontic appliances. This study aims to compare the effect of probiotic tablets combined with regular oral hygiene versus regular oral hygiene alone on gingival status in these patients. The effect of probiotic intake on plaque formation and salivary microbiome composition will be also assessed.Methods and analysisThis is a 3 month single-centre, single blind (clinical and laboratory examiners), parallel group randomised controlled two arm superiority trial. Fifty paediatric patients attending the Postgraduate Orthodontic Clinic at the Hamdan Bin Mohammed College of Dental Medicine (HBMCDM), Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates, who meet the eligibility criteria will be recruited. Block randomisation with 1:1 allocation and concealment of allocation will be carried out. The treatment group will receive probiotic tablets containingStreptococcus salivariusM18 andLactobacillus acidophilustogether with regular oral hygiene versus the control group on regular oral hygiene alone. Clinical examination and collection of saliva for microbiome assay will be carried out at baseline and end of study. Self-reporting by patients will be used to document acceptability and adverse effects. Statistically significant decrease in gingival bleeding on probing in the treatment group will be classified as primary outcome of treatment success. Statistically significant reduction in Plaque Index, Gingival Index and shift in the composition of the oral microbiome in favour of beneficial bacteria are secondary outcomes indicative of efficacy of probiotic intake.Ethics and disseminationEthical approval for the study has been granted by the HBMCDM, MBRU, Institutional Review Board (Reference #: MBRU-IRB-2018–015). Study findings will be disseminated via publication in peer-reviewed journal.Trial registration numberISRCTN95085398

Extensive Frozen Section Examination of Axillary Sentinel Nodes to Determine Selective Axillary Dissection

2001 ◽  
Vol 25 (6) ◽  
pp. 806-808 ◽  
Author(s):  
Umberto Veronesi ◽  
Stefano Zurrida ◽  
Giovanni Mazzarol ◽  
Giuseppe Viale
Keyword(s):  
Axillary Dissection ◽  
Frozen Section ◽  
Sentinel Nodes ◽  
Frozen Section Examination
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