Testicular tumours in children: a single-institutional experience.
OBJECTIVE
To report our experience of testicular and paratesticular tumours in children, as such tumours are rare, and historically yolk sac tumour has been described as the most common lesion in children, but recent reports suggest that benign testicular lesions might be more common.


METHODS
We reviewed retrospectively the records of children treated for testicular tumours from 1998 to 2005. The patients' age, clinical presentation, diagnostic procedures, treatment methods, histopathological findings, and outcome were recorded. Patients aged>144 months and those with non-primary metastatic lesions were excluded.


RESULTS
In all, 11 patients met our criteria, with a mean age of 37 months (range 9 days to 144 months). Pathological analysis revealed teratoma in four patients, yolk sac tumour in two, epidermoid cysts in two, extrarenal nephroblastomatosis in one, and paratesticular rhabdomyosarcomas in two. The most common clinical presentation was a painless testicular mass. Depending on the clinical presentation and pathology, scrotal ultrasonography, tumour markers (alpha-fetoprotein and beta-human chorionic gonadotrophin), and/or staging computed tomography (CT) were obtained in eight patients. All patients had a radical orchidectomy. Three patients had elevated tumour markers that normalized after orchidectomy. CT revealed extensive mediastinal adenopathy in one patient with rhabdomyosarcoma. Chemotherapy was administered to both patients with rhabdomyosarcoma.


CONCLUSIONS
Although there were few patients, most of the lesions were benign tumours, with the most common histological subtype being teratoma. As both malignant and paratesticular lesions occurred at a significant frequency, we would continue to advocate an initial radical inguinal approach at which time testis-sparing could be considered if the preoperative evaluation was favourable, and frozen-section analysis at the time of surgery confirms a benign lesion.
Oottamasathien
Siam
S
Department of Urologic Surgery, Vanderbilt University Medical Center, and Division of Paediatric Urology, Vanderbilt Children's Hospital, Nashville, TN37232-2765, USA. siam.oottamasathien@vanderbilt.edu
Thomas
John C
JC
Adams
Marc C
MC
DeMarco
Romano T
RT
Brock
John W
JW
Pope
John C
JC
D000970:Antineoplastic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009919:Orchiectomy / Q000379:methods*; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000601:surgery; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism
D000970:Antineoplastic Agents; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins