Testicular tumors in infants and children

Abstract

Primary malignant tumors of the testis are uncommon in infants and children. Tumors of germ cell origin are identified most frequently. The clinical presentation is usually due to the presence of an enlarging scrotal mass. Determinations of the serum alpha fetoprotein (AFP) and beta subunit of human chorionic gonadotropin (beta-hCG) levels are helpful for diagnosis and management. All suspected testicular tumors should be surgically evaluated through a high inguinal incision. Postoperative chemotherapy is recommended for some patients with yolk sac tumor and all patients with embryonal rhabdomyosarcoma. Prolonged relapse-free survival is possible for most infants and children with malignant testicular tumors.

TESTICULAR GERM CELL TUMORS IN CHILDHOOD: Treatment Results of 52 Patients

“…The median age at diagnosis varied between 12 and 42 months in the reported series [7][8][9]. The age distribution in our series is similar to that reported in the literature and 82.7% of patients were younger than 3.5 years.…”

“…Retroperitoneal lymph node involvement is less frequent in children than in adults [4] and there is a significant risk of postoperative ejaculatory dysfunction [16]. Therefore, routine RLND in stage I patients has been questioned in 1980's [5,7,9]. In our series, RLND was performed in 10 patients and found positive pathologically in only 3 patients.…”

“…In children who were without clinical or radiological evidence of metastases, only 4.6% of bilateral and 13.7% of unilateral lymph node dissections yielded tumor. There were no differences regarding the relapse-free survival rates of patients with or without RLND [9]. Retroperitoneal lymph node involvement is less frequent in children than in adults [4] and there is a significant risk of postoperative ejaculatory dysfunction [16].…”

“…The age distribution in our series is similar to that reported in the literature and 82.7% of patients were younger than 3.5 years. Painless scrotal swelling is the most common presenting sign in children [1,[7][8][9] and according to Prepubertal Testicular Tumor Registry [10], 87% of 327 patients had presented with scrotal swelling. In our cases, the most common complaint was scrotal swelling similar to the other series.…”

“…Griffin et al [7] and Green [9] showed that chemotherapy did not affect survival rates in patients with localized disease and suggested that orchiectomy alone is effective for stage I disease.…”