title: Testicular and paratesticular neoplasms in prepubertal males.
abstract: OBJECTIVE
  We reviewed the current diagnosis, staging and management of testicular and paratesticular neoplasms in prepubertal males.
  
  
  METHODS
  We performed a medical literature search in English using MEDLINE/PubMed that addressed testicular and/or paratesticular neoplasms in prepubertal males. We then analyzed the literature with respect to individual tumors. We present a concise approach toward the management of these individual tumors.
  
  
  RESULTS
  There is still a predominance of yolk sac tumors in prepubertal males, although some studies suggest that teratomas are more common but underreported due to their benign course in children. Prepubertal males are diagnosed in a fashion similar to that in adult patients with an appropriate history and physical examination. A palpable, nontender mass suggests the diagnosis and prompts scrotal ultrasound and tumor markers. Although treatment for most primary tumors has historically been radical inguinal orchiectomy, most benign tumors can now be managed by testis sparing surgery. The addition of radiation, chemotherapy and/or retroperitoneal lymph node dissection depends on tumor stage and histological type.
  
  
  CONCLUSIONS
  Although it is rare in children, any solid scrotal mass in prepubertal males warrants evaluation for possible testicular or paratesticular neoplasm.
authors.affiliation: Division of Pediatric Urology, Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
authors.forename: Piyush K
authors.initials: PK
authors.lastname: Agarwal
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Palmer
mesh_terms: D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008297:Male; D013736:Testicular Neoplasms / Q000175:diagnosis / Q000628:therapy