Pediatric Testicular Tumors: Contemporary Incidence and Efficacy of Testicular Preserving Surgery

Metcalfe, Peter; Farivar-Mohseni, Hesam; Farhat, Walid A.; McLorie, Gordon A.; Khoury, Antoine E.; Bägli, Darius

doi:10.1097/01.ju.0000097383.09743.f9

Cited by 137 publications

(118 citation statements)

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“…No nosso estudo, a presença do tumor na bolsa escrotal foi a manifestação mais frequente das neoplasias de testí-culo e ocorreu em 55/58 (94,8%) dos pacientes, o que está de acordo com a literatura 5,12 . Interessante foi a queixa de dor em 11/58 (19%), localizada na bolsa testicular, mais frequente em adolescentes que em crianças (p = 0,006), pois geralmente os tumores são assintomáticos e sem sinais flogísticos 5,12 .…”

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“…Interessante foi a queixa de dor em 11/58 (19%), localizada na bolsa testicular, mais frequente em adolescentes que em crianças (p = 0,006), pois geralmente os tumores são assintomáticos e sem sinais flogísticos 5,12 . Das 161 crianças com tumor em bolsa escrotal avaliadas por Yuan et al, 72% apresentaram neoplasias, 13,7% malformações e 14,3% lesões inflamatórias 13 .…”

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“…O fato de essa neoplasia acometer pacientes mais velhos pode ter colaborado para uma maior prevalência em nosso estudo, já que, nos dois trabalhos citados, ela correspondeu a aproximadamente 19% 12,18 . De fato, no estudo de Metcalfe et al, que analisou apenas pacientes com idade < 12 anos, o RMS respondeu por 27% do total, enquanto entre nossos pacientes, de mesma faixa etária, o RMS totalizou 27,8% 5 .…”

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“…O diagnóstico desses tumores em adolescentes é difícil, pois depende das queixas do paciente e de sua predisposição em buscar auxílio médico. Os tumores de testículo são raros e correspondem, no sexo masculino, a 1-2% dos tumores sólidos pediátricos 5 . Sua incidência, segundo o Surveillance, Epidemiology, and End Results (SEER), do National Cancer Institute, foi de 1,27 em 100.000, em menores de 20 anos, no ano de 2008 6 .…”

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Testicular tumors in children and adolescents

Neto¹,

Petrilli²,

Macedo³

et al. 2012

J Pediatr (Rio J)

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Objective: To perform a comparative assessment of the clinical and epidemiological aspects of testicular tumors in childhood and adolescence.Methods: Retrospective analysis of medical records of patients with testicular or paratesticular neoplasms. Patients under 10 years were classified as children and patients between 10 and 20 were classified as adolescents. The obtained results were compared through the twosample test for proportions: non-parametric Mann-Whitney test and log-rank test.Results: 60 patients were admitted in the period from January 1992 to July 2009: 34 children and 26 adolescents with testicular or paratesticular neoplasms. The main manifestations were testicular tumor and scrotal pain. Pain complaints were more common in adolescents (p = 0.006), who presented a mean time from disease onset to diagnosis of 4.9 months, longer than children, who presented a period of 2.3 months from disease onset to diagnosis (p = 0.01). Histological types were as follows: germ cell tumors in 32/60 (53%), rhabdomyosarcomas (RMSs) in 23/60 (38.3%), and other in 5/60 (8.3%). Adolescents presented a higher incidence of RMSs, lymph node metastases (p = 0.003) and distant metastases (p = 0.035). Differences in survival rates among the studied patients were not statistically significant, the only indicative being that survival in RMS cases is longer for children (p = 0.072). Conclusion:Compared to children, adolescents with testicular tumor presented longer time from disease onset to diagnosis, aggressive histological type and advanced illness at diagnosis, despite the small sample analyzed. J Pediatr (Rio J) ResumoObjetivo: Avaliar comparativamente aspectos clínicos e epidemiológicos dos tumores de testículo na infância e adolescência.Métodos: Análise retrospectiva dos prontuários de pacientes com neoplasias de testículo ou paratesticulares. Foram classificados como crianças os menores de 10 anos e como adolescentes os pacientes entre 10 e 20 anos. Os resultados obtidos foram comparados por meio do teste para duas proporções: teste não paramétrico de Mann-Whitney e teste de log-rank. Resultados:No período de janeiro de 1992 a julho de 2009, foram admitidos 60 pacientes: 34 crianças e 26 adolescentes com neoplasias de testículo ou paratesticulares. As principais manifestações foram tumor e dor na bolsa escrotal. A queixa de dor foi mais comum em adolescentes (p = 0,006). Estes apresentaram tempo médio de história de 4,9 meses, mais prolongado do que crianças, com 2,3 meses (p = 0,01). Os tipos histológicos encontrados foram: tumores de células germinativas em 32/60 (53%), rabdomiossarcomas (RMSs) em 23/60 (38,3%) e outros em 5/60 (8,3%). Os adolescentes apresentaram maior frequência de RMSs, metástases em linfonodos (p = 0,003) e a distância (p = 0,035). As diferenças na sobrevida dos pacientes estudados não foram estatisticamente significantes, havendo apenas indicativo de que a sobrevida, nos casos de RMS, é maior nas crianças (p = 0,072). Conclusões:Os adolescentes com tumor testicular apresentaram maior t...

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Testicular tumors in children and adolescents

Neto¹,

Petrilli²,

Macedo³

et al. 2012

J Pediatr (Rio J)

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“…Leydig cell tumors should be treated by simple orchidectomy. Testissparing excision is a reasonable consideration when the volume of normal testicular tissue surrounding the mass is acceptable or the lesion is bilateral [9]. …”

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Leydig Cell Testicular Tumour Presenting as Isosexual Precocious Pseudopuberty in a 5 Year-old Boy

Orihuela¹

2017

EMIJ

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Leydig cell testicular tumors are very rare in children and cause isosexual precocious puberty. We report on a 5-yr-old boy with a Leydig cell tumor of the test is presented with isosexual precocious puberty, penis enlargement, pubic hair, recent growth spurt with deeping of the voice and a seven years on his bone age. An elevated testosterone level 3.72 ng/mL. Right testicle ultrasound showed a hypoechoic nodule and right orchiectomy was performed.Keywords: Leydig-cell tumor; Testicular; Precocious puberty; Neoplasm; Testis normal puberty [1,2]. Precocious puberty can occur because of a disturbance in hypothalamic pituitary gonadal axis (which is called central precocious puberty), or a disturbance outside that axis (which is called peripheral precocious puberty) [3]. Testicular tumors are rare in pediatric patients with an incidence of 0.5-2/ 100,000 children and adolescents [4]. Leydig cell tumors are sex cord Stromal Tumors arising from Leydig cells that are interstitial cells that produce testosterone [5]. They represent the 1-3% of all tumors and more commonly found in adults between 40 and 50 years of age.Leydig cell tumors are universally benign during childhood. The majority of patients present between 5 and 10 yr of age, most commonly with precocious puberty [6]. Androgenization signs include prominent external genitalia, frequent erections, pubic and axillary hair, early growth spurt and deepening of the voice [7]. An elevated testosterone level with low or normal serum gonadotropin, FSH (follicle-stimulating hormone) and LH (luteinizing hormone), levels is consistent with Leydig cell tumor. Ultrasonography is necessary for diagnosis because it is sometimes difficult to detect on physical examination [8]. Leydig cell tumors should be treated by simple orchidectomy. Testissparing excision is a reasonable consideration when the volume of normal testicular tissue surrounding the mass is acceptable or the lesion is bilateral [9]. Case ReportA 5-yr-old boy was referred to the hospital for endocrinology pediatric evaluation of penis enlargement, pubic hair, axillary odor and recent growth spurt with deeping of the voice for over one year. The parents noticed a penis enlargement with pubic hair and frequent erections ( IntroductionPrecocious puberty is defined as the appearance of secondary sex characteristics at a younger age than in the general population, 8 year old in girls and 9 years old in boys as the lowest age of The levels of testosterone was 3.72 ng/ml, the levels of FSH and LH were prepuberal. Testicular Ultrasound showed right testicle measures: 24 x 13 x 18 mm, heterogeneous hypoechogenic nodule measuring 22 x 10 x 20 mm with peripheral vascularization suspicious of malignancy. Left testicle measures: 10 x 7 x 15 mm, homogeneous epididymis having cystic image of 2 x 2 mm.The chest x-ray and the abdominal -pelvic MRI were normal. Following referral to the Urology Team of the hospital, the patient underwent right radical inguinal orchidectomy and pathology examination of the right testi...

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Imaging Scrotal Lumps in Children

Coley

Jayanthi

2011

Scrotal Pathology

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Pediatric Testicular Tumors: Contemporary Incidence and Efficacy of Testicular Preserving Surgery

Cited by 137 publications

References 18 publications

Testicular tumors in children and adolescents

Testicular tumors in children and adolescents

Leydig Cell Testicular Tumour Presenting as Isosexual Precocious Pseudopuberty in a 5 Year-old Boy

Imaging Scrotal Lumps in Children

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