Abstract
Aim: This study reports surgical treatment and its outcome for boys with a testicular tumor, in order to analyze the considerations of testis-sparing surgery (TSS) and investigate whether, in retrospect, treatment was according to a recently developed algorithm. Methods: We retrospectively reviewed boys with testicular tumors who underwent surgical treatment between January 2000 and June 2020 at the Wilhelmina’s Children’s Hospital and the Princess Máxima Center for Pediatric Oncology, The Netherlands. Medical records were searched for clinical characteristics and outcome. Results: We identified 31 boys (median age = 5.5 years) with a testicular tumor, 26 germ cell tumors (GCTs), four sex cord-stromal tumors, and one gonadoblastoma. Seventeen boys (median age = 1.5 years) had malignant and 14 (median age = 3.6 years) had benign tumors. Four boys with benign GCTs were treated with TSS, 25 with radical inguinal orchiectomy (RIO), and 2 with scrotal orchiectomy. No recurrence or testicular atrophy was reported. All boys with benign testicular tumors were treated as suggested by the algorithm, except for one boy treated with RIO. Conclusion: Retrospective analysis of surgical treatment of prepubertal boys with benign testicular tumors showed that TSS appears to be safe, and should be considered based on clinicoradiological data, in line with our algorithm.
Highlights
Testicular tumors are rare, accounting for approximately 1% of cancers in males [1,2]
We suggested the application of an algorithm for determination of the appropriate surgical treatment in prepubertal (
We report the retrospective evaluation of surgical treatment and the outcome for children with a testicular tumor treated in two pediatric centers over the past 20 years
Summary
Testicular tumors are rare, accounting for approximately 1% of cancers in males [1,2]. In men between 14 and 44 years of age, testicular cancer is the most common malignancy [3], testicular tumors constitute only 1% to 2% of all solid tumors in the pediatric population [4]. In children, it shows a bimodal age distribution: in the first three years of life and during or just after puberty, often referred to as prepubertal and (post)pubertal, respectively [5,6]. Type I testicular GCTs usually occur in prepubertal children, and are not germ cell neoplasia in situ (GCNIS)-associated tumors, with initial benign behavior. Age can even be considered as the most important prognostic factor in pediatric GCTs, according to the largest retrospective evaluation of the Maligne Keimzelltumoren (MAKEI) dataset [12]
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