title: High reliability of scrotal ultrasonography in the management of childhood primary testicular neoplasms.
abstract: BACKGROUND
  The role for testis-sparing surgery in the treatment of primary intratesticular lesions in childhood is growing. The reliability of scrotal ultrasonograpy (US) in the management of these lesions is still controversial.
  
  
  METHODS
  Between 1991 and 2007, 383 children and adolescents presented with testicular abnormalities. Ultrasound results and records of patients with primary testicular neoplasms were analyzed.
  
  
  RESULTS
  12 of 383 patients (3.1%) had a histologically proven primary intratesticular neoplasm. Scrotal US was highly sensitive for the detection of these lesions. Patients' mean age at initial US was 6 years (9 prepubertal, 3 juvenile patients). The most frequent symptom was a painless unilateral scrotal mass (75%). Tumor markers or testosterone were elevated in 6/12 boys. Histology was intratesticular germ cell in 7, sexcord stromal tumor in 4 and capillary hemangioma in 1 patient. US correctly distinguished between benign and malignant lesions in all cases. When combined with clinical symptoms, US predicted 75% of histologies. After including hormone and tumor marker levels, a correct preoperative diagnosis was made for all boys with germ cell, and for 75% of boys with sexcord stromal tumor.
  
  
  CONCLUSIONS
  Scrotal US is highly sensitive for the detection of childhood primary intratesticular tumors and, when combined with clinical data, highly reliable for differential diagnosis. It may help clinicians to decide when to opt for testis-sparing surgery.
authors.affiliation: Department of Pediatric Oncology/Hematology, Charité-Universitätsmedizin Berlin, Germany. gesche.tallen@charite.de
authors.forename: G
authors.initials: G
authors.lastname: Tallen
authors.forename: P
authors.initials: P
authors.lastname: Hernáiz Driever
authors.forename: P
authors.initials: P
authors.lastname: Degenhardt
authors.forename: G
authors.initials: G
authors.lastname: Henze
authors.forename: T
authors.initials: T
authors.lastname: Riebel
mesh_terms: D000293:Adolescent; D000465:Algorithms; D014408:Biomarkers, Tumor / Q000097:blood; D002648:Child; D002675:Child, Preschool; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood; D015331:Cohort Studies; D003937:Diagnosis, Differential; D018324:Hemangioma, Capillary / Q000000981:diagnostic imaging; D006801:Humans; D007223:Infant; D008297:Male; D009373:Neoplasms, Germ Cell and Embryonal / Q000000981:diagnostic imaging; D011237:Predictive Value of Tests; D011379:Prognosis; D012611:Scrotum / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D018312:Sex Cord-Gonadal Stromal Tumors / Q000000981:diagnostic imaging; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging*; D013739:Testosterone / Q000097:blood; D014463:Ultrasonography; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D018997:Chorionic Gonadotropin, beta Subunit, Human; D000509:alpha-Fetoproteins; D013739:Testosterone