title: Testicular yolk sac tumors in children: a review of 61 patients over 19 years.
abstract: BACKGROUND
  To describe 19 years of clinical experience managing pediatric patients with testicular yolk sac tumors at the Chongqing Medical University Affiliated Children's Hospital.
  
  
  METHODS
  This study involved a retrospective review of the records of 61 pediatric patients who presented with testicular yolk sac tumor at our institution between 1995 and 2014.
  
  
  RESULTS
  All patients presented with a painless scrotal mass. Serum alpha-fetoprotein (AFP) levels were elevated (n = 15). Ultrasonography identified the yolk sac tumors as solid masses. Color Doppler flow imaging showed rich blood flow inside and around the masses in 84.8% cases. X-ray of the scrotum showed no intrascrotal calcification (n = 38). Inguinal orchiectomy was performed in 60 patients, one case was treated with testis-sparing surgery. In 11 cases, radical dissection of the inguinal lymph nodes was performed. Histological analysis showed pathologies typical of yolk sac tumor including microcapsule and reticular structures, gland tube-gland bubble structures, an embryo sinus structure, and papillary structures. All patients received postoperative chemotherapy. Serum AFP levels returned to normal 1 to 2 months after surgery. No patients treated with surgery in our hospital relapsed.
  
  
  CONCLUSIONS
  Testicular yolk sac tumor presents as a painless scrotal mass, increased serum AFP levels, and a solid mass on ultrasound. Chest radiography and abdominal ultrasound should be used to accurately stage the tumor. We advocate for inguinal orchiectomy for Stage I disease and postoperative chemotherapy to prevent recurrence in the ipsilateral or contralateral testis.
authors.forename: Yi
authors.initials: Y
authors.lastname: Wei
authors.affiliation: Ministry of Education Key Laboratory of Child Development and Disorders; Key Laboratory of Pediatrics in Chongqing, CSTC2009CA5002; Chongqing International Science and Technology Cooperation Center for Child Development and Disorders, Room 806, Kejiao Building (NO,6 Building), No,136, 2nd Zhongshan Road, Chongqing City, Yuzhong District, China. wu-sd@163.com.
authors.forename: Shengde
authors.initials: S
authors.lastname: Wu
authors.forename: Tao
authors.initials: T
authors.lastname: Lin
authors.forename: Dawei
authors.initials: D
authors.lastname: He
authors.forename: Xuliang
authors.initials: X
authors.lastname: Li
authors.forename: Junhong
authors.initials: J
authors.lastname: Liu
authors.forename: Xing
authors.initials: X
authors.lastname: Liu
authors.forename: Yi
authors.initials: Y
authors.lastname: Hua
authors.forename: Peng
authors.initials: P
authors.lastname: Lu
authors.forename: Guanghui
authors.initials: G
authors.lastname: Wei
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009367:Neoplasm Staging; D009373:Neoplasms, Germ Cell and Embryonal / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D009919:Orchiectomy; D011379:Prognosis; D012189:Retrospective Studies; D013736:Testicular Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000628:therapy; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D000509:alpha-Fetoproteins