Removal of testicle tumor

Surgery for a testicular tumour may remove the affected testicle or, in selected cases, just the tumour. Radical inguinal orchiectomy means removing the testicle through an incision in the groin. It is used for known or suspected testicular cancer and allows the tissue to be examined to establish the diagnosis. The groin approach avoids exposing the scrotal skin and its drainage channels to cancer cells.

Testis-sparing surgery removes the mass while preserving the remaining testicle. During the operation, a pathologist examines rapidly frozen tissue to help determine whether it is cancerous. In carefully selected cases with a non-cancerous result, the testicle can be repaired and preserved; otherwise, removal of the whole testicle may be needed.

For testicular germ cell cancer, assessment includes an examination, blood tests for tumour markers, ultrasound of the scrotum and CT scans of the chest, abdomen and pelvis. Removing the affected testicle through the groin is the first treatment step and helps establish the tumour type, local stage and features linked to progression.

A small mass whose nature is uncertain, with negative tumour-marker blood tests, may allow a testis-sparing approach with tissue testing during surgery. Preserving testicular tissue is especially relevant when someone has only one testicle or tumours in both. This is a selected-patient option, not an interchangeable replacement for whole-testicle removal in every cancer.

After surgery, the next choice depends on the tumour type and stage. For stage I seminoma, a type of germ cell cancer, surveillance is preferred when the patient can adhere to monitoring; carboplatin chemotherapy is another option. For stage I nonseminoma, another group of germ cell cancers, options include surveillance or chemotherapy based on risk features in the removed tissue. Cancer that has spread may need chemotherapy. These are decisions about care after the initial operation, rather than equivalent ways to remove the testicular tumour.

Testing frozen tissue can help avoid removing a whole testicle unnecessarily. A 2021 review combined 12 studies and an additional clinical series, covering 1,052 frozen-tissue examinations in men with testicular masses of uncertain nature. About one-third of the tumours examined were correctly identified as suitable for testis-sparing surgery, allowing whole-testicle removal to be avoided at that operation. This describes an immediate surgical decision, not long-term cancer control.

A 2025 single-centre study followed 774 patients with clinical stage I nonseminoma managed with surveillance after testicle removal. Of these, 63 had pure teratoma, a particular tumour type, with or without additional malignant changes called somatic transformation. At six years, the estimated proportion remaining free of relapse was 85.2% in this group and 67.9% in patients with other nonseminoma types. Median follow-up was 61 months. These results describe selected patients under surveillance, not a comparison of testis-sparing surgery with whole-testicle removal; the single-centre setting and follow-up duration also limit conclusions about late relapse.

Fertility deserves attention when planning treatment. Cancer treatments can harm sperm production. Freezing sperm from a semen sample is the main fertility-preservation approach. When that is not possible, surgical retrieval of sperm from the testicle may be considered. For men with testicular cancer who have no sperm in their semen, retrieval can sometimes be performed at the same operation as tumour or testicle removal.

A 2026 study found that after testicle removal, sperm count and forward movement declined while sperm DNA integrity improved. This mixed pattern supports an individual fertility assessment rather than a blanket rule about whether sperm should be frozen before or after surgery.

Removing the tumour does not always end cancer treatment. Examination of the tissue and the cancer stage guide whether surveillance or further treatment is appropriate. For some nonseminoma cancers, surgery to remove remaining masses is recommended after chemotherapy.

Follow-up after testicle removal depends on the tumour type and stage. For stage I disease, surveillance is an active care option, with the ability to attend monitoring central to choosing it for seminoma. The tissue examination also helps determine whether additional treatment is appropriate for nonseminoma.

After chemotherapy for cancer that has spread, imaging is used to assess any remaining masses. CT is used for nonseminoma, while PET imaging can help guide decisions about larger remaining seminoma masses. These checks address care after chemotherapy, not a routine recovery schedule for everyone having testicle surgery.