title: [Clinical analysis of stage I pediatric testicular yolk sac tumors: a report of ten cases].
abstract: OBJECTIVE
  At present, pediatric testicular yolk sac tumor is hard to be diagnosed at early stage, and the treatment strategy for this disease after radical inguinal orchiectomy is uncertain. This study was to summarize our experience in diagnosing and treating clinical stage I pediatric testicular yolk sac tumors.
  
  
  METHODS
  Clinical data of ten patients with clinical stage I pediatric testicular yolk sac tumors treated from July 2001 to June 2007 were analyzed.
  
  
  RESULTS
  Testicular masses with low or uneven echoes were detected by B ultrasound in 11 testes of ten patients. The serum level of alpha fetoprotein (AFP) was increased in nine patients. Radical inguinal orchiectomy (RIO) was performed for all patients whereas chemotherapy was not administered preoperatively. Pathology examination was used to confirm the diagnosis of yolk sac tumor. One patient with vascular invasion and another one with bilateral testicular yolk sac tumor received cisplatin-based adjuvant chemotherapy. Retroperitoneal lymph node dissection (RPLND) was not performed in these patients. No recurrence was found in nine patients during follow-up with a mean of 3 years. The patient with bilateral testicular tumor had retroperitoneal and lung metastases at 23 months after adjuvant chemotherapy, and achieved complete remission again after salvage chemotherapy.
  
  
  CONCLUSIONS
  With the combination of B ultrasound and serum AFP level, we can assess and diagnose stage I pediatric testicular yolk sac tumor. RIO could be used to treat it with good outcomes, while RPLND is not necessary. Chemotherapy is recommended to treat patients with high-risk of relapse.
authors.affiliation: State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China.
authors.forename: Yun-Lin
authors.initials: YL
authors.lastname: Ye
authors.forename: Zi-Ke
authors.initials: ZK
authors.lastname: Qin
authors.forename: Fang-Jian
authors.initials: FJ
authors.lastname: Zhou
authors.forename: Hui
authors.initials: H
authors.lastname: Han
authors.forename: Zhuo-Wei
authors.initials: ZW
authors.lastname: Liu
authors.forename: Shao-Long
authors.initials: SL
authors.lastname: Yu
authors.forename: Yong-Hong
authors.initials: YH
authors.lastname: Li
authors.forename: Zhuang-Fei
authors.initials: ZF
authors.lastname: Chen
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001761:Bleomycin / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D002675:Child, Preschool; D002945:Cisplatin / Q000627:therapeutic use; D018240:Endodermal Sinus Tumor / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000556:secondary / Q000628:therapy; D005047:Etoposide / Q000627:therapeutic use; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000188:drug therapy / Q000556:secondary; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy / Q000379:methods; D012074:Remission Induction; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy / Q000556:secondary; D013736:Testicular Neoplasms / Q000097:blood / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin