It’s not uncommon to discover testicular cancer in men when they are examined by ultrasound during an evaluation for infertility, Israeli researchers report. They therefore suggest that “routine sonographic screening of infertile men” may be worthwhile.

Dr. Raanan Tal of Tel Aviv University and colleagues reviewed the medical records of 150 men who, over a 10-year period, had had a testicle removed because of cancer.

The team found the cancer had only been spotted in 11 of the men when they were being evaluated for infertility, according to a report in the medical journal Fertility and Sterility.

The tumors had shown up on an ultrasound exam. Most were small and located centrally within normal testicular tissue. Because of this, eight of these tumors could not be felt by physical examination.

Also, cancer markers in blood tests that usually raise suspicions were normal in all but one man.

The investigators conclude that the “use of trans-scrotal sonography enables early diagnosis of small nonpalpable tumors. Further studies are warranted to establish the yield of routine sonographic screening for infertile men.”

Tal added, “The need to treat a young patient with testicular cancer while preserving future fertility poses a real challenge to the urologist.”

SOURCE: Fertility and Sterility, August 2004.