Testicular Tumors In Children: A Single Institution Experience

Abstract

PURPOSE Testicular tumors account for 1-2% of all paediatric solid tumors. We describe a single center experience in the diagnosis and surgical treatment of testicular tumors in a paediatric population. MATERIAL AND METHODS Research Ethics Board approved retrospective chart review of testicular tumors treated at our institution from 1990-2008. RESULTS Twenty-six patients with 27 tumors, 15 prepubertal and 12 post-pubertal. Median age 7.4 years (Quartiles 1st: 0.7; 3rd: 15.4). Median follow up 36 months (Quartiles 1st: 14.1; 3rd: 80.7). Painless testicular mass in 52%(14/27). Alpha-fetoprotein(AFP) was high in 80%(8/10) and 12% (2/17) of malignant and benign tumors respectively. Human Chorionic Gonadotropin(HCG) was high in 20%(2/10) of the malignant tumors, and both patients were post-pubertal. Benign and malignant tumors were 63%(17/27) and 37%(10/27) respectively. Benign lesions were present in 73%(11/15) of prepubertal and 50%(6/12) of post-pubertal. AFP was normal in 82%(9/11) of benign and high in 100%(4/4) of malignant prepubertal patients (p=0.011). Pathology: 82%(22/27) germ cell tumors, 15%(4/27) gonadal stromal and 3%(1/27) cystic dysplasia. Radical and partial orchiectomy was performed in 89%(24/27) and 11%(3/27) respectively. Stage I was found in 88.9%(24/27) and II, III and IV in 3.7 %(1/27) each. There was no death during the follow up. CONCLUSIONS Benign testicular tumors were more frequent in our series. As most prepubertal tumors were benign (73%) and AFP was high in all prepubertal malignant tumors, partial orchiectomy in patients younger than 12 years with a normal AFP could be considered. HGC had no value on assessment of tumors in prepubertal age.