TESTIS-SPARING SURGERY FOR BENIGN TESTICULAR TUMORS IN CHILDREN

Abstract

No AccessJournal of UrologyOncology1 Jun 2001TESTIS-SPARING SURGERY FOR BENIGN TESTICULAR TUMORS IN CHILDREN J.S. VALLA and THE GROUP D'ETUDE EN UROLOGIE PÉDIATRIQUE* J.S. VALLAJ.S. VALLA and THE GROUP D'ETUDE EN UROLOGIE PÉDIATRIQUE* View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)66184-8AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In this retrospective survey we identify preoperative and intraoperative criteria of nonmalignancy and analyze the result of conservative treatment of a testicular mass. Materials and Methods: A total of 22 surgeons responded to a questionnaire concerning lesions treated during the last 15 years in children between 0 and 15 years old. By definition α fetoprotein and β human chorionic gonadotropin are within the normal limits at this age. The results were evaluated regarding evolution, growth of the preserved testis and local or distant recurrences. Results: Benign tumor of the testis (83 cases) represented 48% of all cases. Orchiectomy was performed in 27 cases and conservative treatment in 56. The final histopathological diagnosis was benign germinal tumor in 48 cases, cysts in 18, gonadal stromal tumor in 13 and rare lesions (lipoma, hemangioma) in 4. No definitive clinical criteria of nonmalignancy were identified but some symptoms were suggestive of nonmalignancy. Ultrasound results were more conclusive and provided the diagnosis of teratoma, epidermoid cyst and particularly simple cyst. The conservative treatment performed 56 times was a simple biopsy in 2 children with bilateral lesions and enucleation in 52. Enucleation was performed in 43% of cases using a pedicle clamp and in 50% with frozen section. The frozen section was changed in 12 cases due to therapeutic decision for preservation (10) and orchiectomy (2). There were no contradictions between the definitive histopathological examination and frozen section. Secondary orchiectomy was performed for neonatal granular tumor. Average followup in 56 cases of conservative treatment was 4.8 years (range 6 months to 15 years). Neither secondary testicular atrophy nor any local or distant recurrence was recorded. Conclusions: A testicular tumor in children has a 50% chance of being benign. Treatment selection according to some clinical, biological, radiological and frozen section findings should allow us to decide on testis-sparing surgery without additional oncological risk, and with an aesthetic, psychological and functional benefit. References 1 : Bilateral testis tumors in an infant: synchronous teratoma and epidermoid cyst. J Urol1995; 153: 1077. 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Link, Google Scholar From the Foundation Lenval, Hôpital pour Enfants, Nice, France© 2001 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byAshley R, McGee S, Isotaolo P, Kramer S and Cheville J (2018) Clinical and Pathological Features Associated With the Testicular Tumor of the Adrenogenital SyndromeJournal of Urology, VOL. 177, NO. 2, (546-549), Online publication date: 1-Feb-2007.Henderson C, Ahmed A, Sesterhenn I, Belman A and Rushton H (2018) Enucleation for Prepubertal Leydig Cell TumorJournal of Urology, VOL. 176, NO. 2, (703-705), Online publication date: 1-Aug-2006.SHUKLA A, WOODARD C, CARR M, HUFF D, CANNING D, ZDERIC S, KOLON T and SNYDER H (2018) Experience With Testis Sparing Surgery for Testicular TeratomaJournal of Urology, VOL. 171, NO. 1, (161-163), Online publication date: 1-Jan-2004.SHUKLA A, HUFF D, CANNING D, FILMER R, SNYDER H, CARPINTIERI D and CARR M (2018) Juvenile Granulosa Cell Tumor of the Testis: Contemporary Clinical Management and Pathological DiagnosisJournal of Urology, VOL. 171, NO. 5, (1900-1902), Online publication date: 1-May-2004.LEE S (2018) EPIDEMIOLOGICAL AND CLINICAL BEHAVIOR OF PREPUBERTAL TESTICULAR TUMORS IN KOREAJournal of Urology, VOL. 172, NO. 2, (674-678), Online publication date: 1-Aug-2004.POHL H, SHUKLA A, METCALF P, CILENTO B, RETIK A, BAGLI D, HUFF D and RUSHTON H (2018) PREPUBERTAL TESTIS TUMORS: ACTUAL PREVALENCE RATE OF HISTOLOGICAL TYPESJournal of Urology, VOL. 172, NO. 6 Part 1, (2370-2372), Online publication date: 1-Dec-2004. Volume 165Issue 6 Part 2June 2001Page: 2280-2283 Advertisement Copyright & Permissions© 2001 by American Urological Association, Inc.Keywordssurgeryneoplasm, benigntestisMetricsAuthor Information J.S. VALLA More articles by this author THE GROUP D'ETUDE EN UROLOGIE PÉDIATRIQUE* Members: Doctors Coupris (Angers), Van Kote (Aulnay sous Bois), Wallon (Bordeaux), Ravasse-Delmas (Caen), Geiss (Colmar), Dyon-Jacquier (Grenoble), Collard (Le Havre), Weill (Le mans), Alessandrini-Guys-Louis-Borrione (Marseille), Galifer (Montpellier), Heloury (Nantes), Esposito (Naples), Valla-Leculee (Nice), Aigrain-Audry-Lottman-Martelli (Paris), Levard (Poitiers), Mitrofanoff (Rouen), Chavrier (St Etienne), Robert-Lacombe-Swarc (Tours), Ramaherrisson (Valencienne). More articles by this author Expand All Advertisement PDF downloadLoading ...