Testicular Tumors in Children



Testicular Tumors in Children


Kenan Ashouri

Fawaz M. Ashouri





  • Pediatric testicular tumors are rare in the prepubescent male (Figure 54.1).


  • Germ cell tumors (GCTs) comprise the majority of testicular tumors in the pediatric population.


EPIDEMIOLOGY AND ETIOLOGY



  • The most common type of GCT in the pediatric population is yolk sac tumors, followed by teratomas.1



    • Yolk sac tumors are malignant and express alpha fetoprotein (AFP).


    • In contrast to adults, teratomas in children are often benign and lack immature components.2,3


  • Epidermoid cysts are another common benign testicular tumor in children.


  • The next most common category is gonadal stromal tumors, including sertoli cell tumors, leydig cell tumors, and juvenile granulosa cell tumors, in respective order of approximate incidence.


  • Seminomatous GCTs are rare in children.


  • Paratesticular rhabdomyosarcomas are the most common malignant tumor of the paratesticular structures.



    • Often arise from the spermatic cord, tunicae, or epididymis.


    • Highly aggressive and warrant retroperitoneal lymph node dissection (RPLND) and metastatic workup.4


  • Secondary tumors are most commonly leukemia or lymphoma.


  • Cryptorchidism is classically associated with an increased relative risk of GCT (RR˜3-8) in the undescended testicle, which is only reduced but not eliminated (RR˜2-3) after prepubertal orchiopexy.5







Figure 54.1 Inguinal anatomy. Note: Scarpa fascia (not depicted) is more predominant both near the pelvis and in children. (Reprinted with permission from Detton AJ. Grant’s Dissector. 16th ed. Philadelphia, PA: Wolters Kluwer; 2017.)


CLINICAL PRESENTATION



  • Testicular tumors typically present as a painless testicular mass incidentally found by the patient or parent or on clinical examination.


  • There is often an associated hydrocele occurring in ˜1 in 5 patients.6


May 5, 2019 | Posted by in PEDIATRICS | Comments Off on Testicular Tumors in Children
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