+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Surgery in infants and children with testicular and paratesticular tumours: a single centre experience over a 25-year-period

Surgery in infants and children with testicular and paratesticular tumours: a single centre experience over a 25-year-period

Klinische Padiatrie 219(3): 146-151

Testicular and even more paratesticular tumours in children are rare. The aim of the study is to characterise the spectrum of these lesions with focus on the feasibility and effectiveness of testis sparing surgery. Twenty-four boys treated between 1980 and 2004 at the University Leipzig Medical Centre were evaluated. At presentation patients were between 5 months and 18 years old (median 23 months). Generally a high rate of malignant or potentially malignant tumours was observed. The majority of these tumours occurred in the first three years of age. The spectrum of testicular tumours comprised 13 germ cell tumours (6 yolk sac tumours, 6 teratomas, 1 embryonal carcinoma) and 4 sex cord stromal tumours (2 Leydig's cell, Sertoli's cell, granulosa cell). Both Leydig's cell tumours were endocrine active. Further on, we observed 3 boys with paratesticular rhabdomyosarcoma (RMS), and three with testicular and paratesticular metastases (Wilms' tumour, neuroblastoma, leukaemia). Serum alpha1-fetoprotein (AFP) was clearly elevated in 5 of 6 yolk sac tumours but remained within normal limits concerning the other entities. Human chorionic gonadotrophin was normal in all cases tested. During the observation period high inguinal orchidectomy was the surgical standard method. Dependent on tumour histology, stage and the recommended treatment schedule postoperative chemotherapy was added. Testis sparing surgery was performed in 3 boys with primary testicular tumours (2 Leydig's cell, mature cystic teratoma). Local relapses were not observed. Systemic relapses occurred in 3 cases (2 RMS, leukaemia). During a median follow up of 5 years all patients with primary testicular tumours survived event free. Meta-analysis of the recent literature revealed that testis sparing surgery is feasible and save in prepubertal boys after exclusion of a malignant tumour. If a testis sparing approach is planned, the following criteria are essential: 1. The presence of a well defined circumscribed nodule confirmed by imaging. 2. Normal levels of serum AFP and hCG. 3. The presence of sufficient healthy testicular parenchyma. However, the high rate of malignant or potentially malignant tumours suggests that high inguinal orchidectomy should remain the surgical standard of therapy.

(PDF emailed within 0-6 h: $19.90)

Accession: 056027996

Download citation: RISBibTeXText

PMID: 17525908

DOI: 10.1055/s-2007-973847

Related references

Testicular and paratesticular pathology in infants and children: the histopathological experience of a tertiary paediatric unit over a 17 year period. Pediatric Surgery International 23(9): 867-872, 2007

Prepubertal testicular and paratesticular tumors in China: a single-center experience over a 10-year period. Journal of Pediatric Surgery 47(8): 1576-1580, 2013

Prepubertal testicular and paratesticular tumors in China a single-center experience over a 1-year period. 2012

Testicular and paratesticular tumours in children: 30 years' experience. Australian and New Zealand Journal of Surgery 69(7): 505-508, 1999

Epidemiologic study of 230 cases of testicular/paratesticular tumors or masses: 15-year experience of a single center. Journal of Pediatric Surgery, 2017

Testicular and paratesticular pathology in the pediatric population: a 20 year experience at Riley hospital for children. Pathology, Research and Practice 209(7): 404-408, 2014

Clinicopathological characteristics and treatment outcomes of adult patients with paratesticular rhabdomyosarcoma (PRMS): A 10-year single-centre experience. Canadian Urological Association Journal 6(1): 42-45, 2012

Prepubertal testicular tumours: Should testicular-sparing surgery be considered? A single-institution experience and review of the literature. Arab Journal of Urology 12(2): 130-136, 2015

Fungal infections in children in the early postoperative period after cardiac surgery for congenital heart disease: a single-centre experience. Interactive Cardiovascular and Thoracic Surgery 23(3): 431-437, 2016

Laparoscopic versus Open Surgery in Complicated Appendicitis in Children Less Than 5 Years Old: A Six-Year Single-Centre Experience. Surgery Research and Practice 2016(): 4120214-4120214, 2016

Ten-year experience with testicular cancer at a tertiary care hospital in a resource-limited setting: a single centre experience in Tanzania. World Journal of Surgical Oncology 12(): 356-356, 2015

Single-Centre 20-Year Experience with Surgical Treatment of Thymic Tumours. Acta Chirurgica Belgica 115(1): 52-61, 2017

Single-centre 20-year experience with surgical treatment of thymic tumours. Acta Chirurgica Belgica 115(): 52-61, 2015

Testicular Microlithiasis: Is Sonographic Surveillance Necessary? Single Centre 14 Year Experience in 442 Patients with Testicular Microlithiasis. Ultraschall in der Medizin 37(1): 68-73, 2015

Bilateral testicular germ cell tumours in patients with initial stage I disease: prevalence and prognosis--a single centre's 30 years' experience. European Journal of Cancer 34(9): 1363-1367, 1998