The diagnosis and treatment of testicular yolk sac tumors in children

Abstract

Objectives To explore the diagnosis and treatment of testicular yolk sac tumors in children.Methods The clinical data of 12 cases (aged between 2 months to 8 years) with testicular yolk sac tumors was retrospectively analyzed.Most of children presented with painless scrotal mass.All cases accepted the serum alpha-fetoprotein (AFP) measurement,chest slice and(or) chest CT scan,testicle Magnetic Resonance Imaging (MRI)check,testicular and retroperitoneal ultrasonography.In order to determine procedures of surgical operation,testicular rumors were frozen sectioned to perform pathological examination during operation.Chemotherapy was performed according to the character of tumour after operation.Most patients underwent orchiectomy,while retroperitoneal lymph node resection was performed in certain circumstance.All cases were followed up for about 3 months to 2years postoperatively,with surveillance of AFP,testicular and retroperitoneal ultrasonography,and chest X-ray.Results Pathology the result is all YST Of the 12 cases,11 cases underwent high ligation and spermatic testicular resection,and1 case underwent testicular sparing enucleation surgery,and 12 cases were followed up,mean time 16 months,and 10 cases (stage Ⅰ) accepted one course of chemotherapy,1 case refuses a chemotherapy after testicular sparing enucleation surgery,1 case because the financial straits didnt go a chemotherapy,postoperatively 6 month the liver lung abdomen pelvic cavity,skeleton metastasis,retroperitoneal lymph the knot extensively metastasis to oppress inferior vena cava result to inferior vena cava obstruction syndrome,give up a treatment;1 cases under-went reoperation and re-chemotherapy because of AFP reoccurrence,PET check hint the scrotum remain to relapse(again surgical operation) tumors recrudescence,and 1 case retroperitoneal metastasis.Conclusions Children with tesitcular yolk sac tumors in stage Ⅰ can be managed with high ligation and spermatic testicular resection,and those in stage Ⅱ-Ⅳcan be done with high ligation and spermatic testicular resection,and retroperitoneal lymph nodes resection,and chemotherapy. Key words: Testicular Neoplasms