Clinical analysis of testicular tumor in 76 children / 中华实用儿科临床杂志

ABSTRACT

Objective To summarize the management and diagnosis of testicular tumors in children.Methods The clinical characteristics, diagnosis, treatment and outcome of patients with pediatric testicular tumors, who were referred to Department of Pediatric Surgery, Shengjing Hospital of China Medical University from January 2003 to December 2013 ,were analyzed retrospectively.Results All of the 76 prepubertal patients were diagnosed initially with a painless scrotal mass.The mean age of the patients at diagnosis ranged from 1 to 156 months[mean(32.3 ±4.4) months].There were 39 cases(51.3％) with ages of0-1 years,18 cases (23.7％) with ages of 1-3 years,10 cases (13.2％) with ages of ＞ 3-7 years,9 cases(11.8％) with ages of ＞ 7-14 years.There were 37 cases in left side and 39 cases in right.And there were 59 cases (77.6％)of benign tumors and 17 cases(22.4％)of malignant tumors.Of the benign tumors,42 cases(55.2％)were teratomas, including 34 cases of mature teratoma and 8 cases of immature teratoma;11 cases were epidermoid cyst;11 cases were other benign tumors as lymphangioma.Among the 17 cases of malignant tumors, 16 cases (21.1％) were yolk sac tumors, which were I stage;1 case was embryoma.Thirty-three patients had abnormal alpha fetoprotein (AFP)concentrations before surgery,including 9 patients with mature teratoma,7 patients with immature teratoma, 16 patients with yolk sac tumors, 1 patient with embryonal carcinoma of testis.Of the 59 cases of benign tumors,testis-sparing surgery was done in 50 tumors, the other 9 patients underwent testis-excising because of tumor severely oppressing testis.All the 17 cases of malignant tumors underwent testis-excising.There were 76 cases in the follow-up.One patient with yolk sac tumor died for pulmonary metastasis during the follow-up.Others were alive and free of tumor recurrence.Conclusions The age range of the prepubertal testicular onset was 1 year or younger, most of the tumors were benign, and the most common subtype was teratoma.AFP highly expressed in yolk sac tumors, it was help to diagnosis.Testis-sparing surgery should be performed for the benign tumors and testis-excising for the malignant tumors.