Reply by Authors
We agree that the ideal strategy in patients with an SMT would be to follow them with periodic US and perform surgery only in those who show significant growth during followup. This is our actual policy in masses less than 5 mm in diameter. In this group few patients required surgical exploration during followup. It is likely that in cases of such small lesions strict surveillance may not change the progression of germinal tumors, as reported by Bieniek et al, who noted a mean lesion diameter of 4.14 2.0 mm (reference 1 in Editorial Comment).