Testicular tumours in prepubertal children: about eight cases

Background: To analyze the spectrum of testicular tumors in prepubertal children and the therapeutic resultants in an unselected population. Materials and Methods: Our hospital database was analyzed for testicular tumors from January 1995 to December 2010 concerning clinical presentation; treatment and therapeutic results. Results: Eight patients were operated on because of testicular tumors. In six cases (75) the tumor was benign: benign teratoma (four cases); epidermoid cyst (one case) and immature teratoma (one case). Two patients (25) had a malignant tumour: yolk-sac tumour (two cases). All this children underwent surgery. Radical inguinal orchidectomy was performed in six cases and conservative surgery was performed in two cases. One patient has received adjuvant chemotherapy. Follow-up was uneventfully three years after primary surgery. Conclusion: In prepubertal children; most testicular tumours are benign. If tumour markers were negative testis-preserving surgery can be proposed; complete excision of the tumour should be ascertained. In the case of testicular teratoma; the possibility of contralateral tumour should be considered in the follow-up

[Liver injuries in children: the role of selective non-operative management]

Trauma remains the leading cause of mortality in the pediatric population. Liver injuries occur commonly in blunt abdominal trauma. To assess the selective non-operative management of liver injuries in children. A retrospective review of 51patients with a discharge diagnosis of traumatic liver injuries at Tunis Children's Hospital, over a 14-year period from 1996 to 2009. We identified 51 patients with liver trauma. The median age was 7 years. Boys accounted for 58% [n= 30], and the most common cause was traffic accident. Head injuries were the most common associated injuries. Forty-nine patients [96%] required non-operative management without complications. The mean in-hospital stay was 10 days in this group. The ultrasound demonstrated complete resolution and healing after 3-6 months. Two patients underwent surgery for hemodynamic instablity. The mortality rate was 0.2%. Safe, non-operative management involves careful serial examination, a CT scanning facility and close monitoring of the patient in a fully equipped high-dependency unit with trained staff to run it. Even though most patients can be treated non-operatively the challenge is to identify the severely injured child early and institute aggressive resuscitation and expedite laparotomy