title: Congenital juvenile granulosa cell tumor of the testis in newborns.
abstract: BACKGROUND
  Granulosa cell tumor of the testis is a rare intermediate stromal cell tumor that can be distinguished in the adult and juvenile type. The juvenile type is the most common reason for scrotal swelling in newborns under the age of six months. Less than fifty cases of this disease entity have been reported in the literature.
  
  
  METHODS
  In the following article, two newborn patients with scrotal swelling and a histological confirmation of juvenile granulosa cell tumor of the testis will be presented.
  
  
  RESULTS
  Case 1: A newborn patient presented with massive scrotal swelling. Sonography of the testicle exhibited a multiple septic and cystic enlargement of the testicle without distinction of the testicular parenchyma being possible. The laboratory findings demonstrated normal testosterone levels, beta-HCG and inhibin-B levels as well as an increased alpha-fetoprotein level of 35.350 ng/dl. Due to clinical and sonographic findings, an inguinal exploration and later, due to the impossibility of distinction of the testicular parenchyma, an inguinal orchiectomy of the right testicle was performed. Case 2: The clinical and sonographic examination of a newborn patient demonstrated a suspicious process of the left testicle. Sonography exhibited an enlarged testicle with cystic formations with the distinction of the testicular parenchyma not being possible. The laboratory findings demonstrated normal testosterone levels, beta-HCG and inhibin-B levels as well as an increased alpha-fetoprotein level of 9.038 ng/dl and LDH of 768 U/I. An inguinal orchiectomy of the left testicle was performed. In both cases, a histological diagnosis of juvenile granulosa cell tumor of the testis was made.
  
  
  CONCLUSIONS
  These two aforementioned cases demonstrate that juvenile granulosa cell tumor of the testis is a benign disease encountered in newborns, which exhibits an excellent prognosis. Inguinal orchiectomy is the therapy of choice. After surgical removal of the involved testicle is performed no further management is required.
authors.affiliation: Department of Urology, St. Antonius Hospital, Gronau, Germany. Zugor@web.de
authors.forename: Vahudin
authors.initials: V
authors.lastname: Zugor
authors.forename: Apostolos P
authors.initials: AP
authors.lastname: Labanaris
authors.forename: Jörn
authors.initials: J
authors.lastname: Witt
authors.forename: Alexander
authors.initials: A
authors.lastname: Seidler
authors.forename: Karl
authors.initials: K
authors.lastname: Weingärtner
authors.forename: Günter E
authors.initials: GE
authors.lastname: Schott
mesh_terms: D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000378:metabolism; D006106:Granulosa Cell Tumor / Q000151:congenital / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D007265:Inhibins / Q000378:metabolism; D008297:Male; D009919:Orchiectomy / Q000379:methods; D011379:Prognosis; D012008:Recurrence; D012611:Scrotum / Q000473:pathology; D013736:Testicular Neoplasms / Q000151:congenital / Q000473:pathology*; D013737:Testis / Q000378:metabolism; D014463:Ultrasonography / Q000379:methods; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; C422364:inhibin B; D007265:Inhibins