Management Of Pediatric Testicular Tumors: Diagnosis, Therapy, And Follow-Up

Main Category: Pediatrics / Children's Health
Also Included In: Urology / Nephrology
Article Date: 30 Apr 2009 - 3:00 PDT

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UroToday.com - Testicular tumors are far more common in adults than in children, often resulting in basing the management of the pediatric disease on the adult experience. The entities are similar in the fact they both typically present with a mass, are treated with surgery, and are sensitive to platinum based chemotherapy. Nonetheless, differences exist between testis tumors occurring in children and those in adults. The differences typically involve tumor histopathology, malignant potential, and pattern of metastatic spread along with morbidity and preservation of testicular function. The differences between the two groups warrant distinct approaches to these patients.

Dr. Steffens et al. provide an algorithm for the surgical management of prepubertal testis tumors. The data is from the Prepubertal Testis Tumor Registry by the Urologic Section of the American Academy of Pediatrics as well as a literature review.

Based on their study:

1. Benign tumors can be discharged from any follow-up after surgery.


2. Children with stage I yolk sac tumors should be monitored closely with periodic AFP tumor marker evaluation and imaging according to the primary dissemination (eg, ultrasound, chest X-ray, and computed tomography).


3. Recurrent or metastatic yolk sac tumors should be treated with platinum-based chemotherapy and appropriate follow-up.


4. Retroperitoneal lymph node dissection is not recommended except for patients with residual retroperitoneal masses following chemotherapy.


5. Aggressive treatment is warranted for metastatic Sertoli cell and metastatic undifferentiated stromal tumors.

It was a pleasure reading this well written and informative article as rarely do I have the opportunity to view a journal written in a language other than English. The sharing of information today is critical as we can coalesce data and thoughts to further progress in medicine.

Steffens J, Treiyer A, Calaminus G
Urologe A. 2009 Apr;48(4):359-63.
doi:10.1007/s00120-009-1944-1

Written by UroToday.com Medical Editor Pasquale Casale, MD

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