Prepubertal Testis Tumors: Actual Prevalence Rate of Histological Types

Abstract

We found that benign lesions represent the majority of primary testis tumors (74%), with the most common histological type being teratoma (48%). The reported high prevalence rates of prepubertal yolk sac tumors probably results from a reporting bias, since benign tumors are less likely to be submitted to tumor registries. Therefore, the primary operative approach to the majority of testis tumors in boys 12 years and younger should entail testis sparing surgery. Orchiectomy should be reserved for histologically confirmed malignancy based on increased preoperative alpha-fetoprotein and/or frozen section analysis of the tumor.

Testicular yolk sac tumor simulating acute scrotum in an infant

“…Dördüncü gün yapılan kontrol muayenesinde bulgularının değişmemesi ve hatta testisin büyümesi ve skrotal hassasiyet gelişmesi üzerine hasta kliniğimize refere edildi. (1,2) . Dört büyük çocuk has- …”

“…Tüm çocukluk çağı solid tümörlerinin % 1-2'sini oluştururlar ve 0.5-2/100.000 oranında görülürler (1) . Testis tümörleri primer olabildiği gibi; çocuklarda tümör metastazları da sık görül-mektedir ve bu metastazlar genellikle lenfoid neoplazm orijinlidir (2) .…”

Testicular masses and surgical point of view in the pediatric age group

“…Bu tür olgularda %30'a kadar çıkan bilateralite olasılığı unutulmamalı ve gonadektomide bu özelliğe dikkat edilmelidir (10)(11)(12)(13) .…”

“…Olguların %10 kadarında tümör aktif olarak hormon salgılar ve jinekomasti gözlenebilir. Sertoli hücreli tm olgularında genetik özellik gözlenebilir ve Peutz Jeghers sendromu eşlik edebilir (10)(11)(12)(13) .…”

Inguinoscrotal pathology

“…They found teratoma in 48% of children, YSTs in 15%, and epidermoid cyst in 14%; other types were juvenile granulosa cell in 5%, Leydig cell in 4%, Sertoli cell in 3%, and mixed gonadal stromal in 1%. 13 A pathognomonic pathology finding in YSTs are Schiller-Duval bodies, described as a small papilla with a central fibrovascular core that protrudes into a central cystic space. Around 80-90% of YSTs are Stage I, but up to 20% can have hematogenous lung metastases at presentation, leaving the retroperitoneum spared; that is the reason why retroperitoneal lymphadenectomy is not commonly done unless there is an elevated AFP or retroperitoneal metastases post-chemotherapy.…”