Introduction: Testis sparing surgery is now a well known surgical technique for small testicular masses. The candidate are patients with normal pre operative testosterone (if fertility preservation is required), small masses (under 2 cm, or not more then 1/3 of the testicular volume), normal value of serum markers for testicular cancer (bHCG, aFP, LDH), testicular masses in monorchid patients and in case of bilateral tumors. Methods: We conducted a retrospective study including the period from February 2021 to August 2022. Our cohort of patients is composed by 4 patients with small testicular masses who underwent testis sparing surgery. The mean age was 36 years (27-57). BMI was > 25 in 50% of patients. One patient reported cryptorchidism history. One patient referred anabolic steroids abuse in the past. None of them had previous history of testicular cancer. A testicular lamp was palpable in 2 patients.The mean lesion size was 0,7 cm (0,5-1,1). 2 patients presented with testicular pain, while two others patient had incidental diagnosis during routinary assessment for infertility and hypogonadotropic hypogonadism. For each patient US scan, tumor markers serum level, were performed. Tumor markers were within the normal limits in 100% of patients. Results: The frozen sections assessment detected correctly benign tumors in 3 out of 4 patients: Adenomatoid tumor 2 (50%), Leydig cell tumor 1 (25%). A single malignant case was correctly identified as seminomatous proliferation in 1 patient; subsequently orchiectomy was performed, histologic examination confirmed Seminoma tumor plus Granulosa Cell Neoplasia In Situ (GCNIS). No one of the four patients developed post-op complications. Each patient is still in a follow-up program that includes periodic imaging surveys and clinical examinations. Conclusions: Testis sparing surgery is safe and effective in selected patients for small, benign masses and in the setting of bilateral disease or tumor in a solitary testis. SOURCE OF Funding: None
