Korean J Urol.  2013 Jun;54(6):399-403.

Prepubertal Testicular Tumors in Korea: A Single Surgeon's Experience of More Than 20 Years

• Baik K
• Kang M
• Park K
• Choi H

Abstract

PURPOSE
To present clinical and histological features of prepubertal testicular tumors through the analysis of the long-term experiences of a single surgeon.
MATERIALS AND METHODS
The charts of 48 children treated for testicular tumors from 1986 to 2010 were retrospectively reviewed. All patients underwent radical orchiectomy. The patients' ages, clinical presentations, histopathological findings, kinetics of tumor markers, and outcomes were recorded.
RESULTS
The patients' median age at the initial diagnosis was 19.5 months (range, 3 to 84 months). All patients presented with either a palpable mass (76%) or scrotal size discrepancy (24%). Compared with a palpable mass, scrotal size discrepancy led to delay in diagnosis by 5 months. Regarding histology, yolk sac tumors and teratomas accounted for 53% and 36% of the tumors, respectively. The mean preoperative alpha-fetoprotein (AFP) level was significantly higher in patients with yolk sac tumors than in those with teratomas (4,600 ng/mL vs. 6.3 ng/mL), and only one patient with a teratoma had a preoperative AFP value higher than 20 ng/mL. Following radical orchiectomy, 72%, 8%, and 16% of patients with a yolk sac tumor showed normalization, persistent elevation, and relapse after transient lowering of AFP, respectively. Preoperative AFP was greater in patients with non-normalization than in those with normalization. Five of six patients with non-normalization showed evidence of either vascular invasion or endolymphatic tumor emboli.
CONCLUSIONS
We found a higher number of yolk sac tumors than teratomas in patients with prepubertal testicular tumors. AFP was the most useful marker in the diagnosis and follow-up of childhood yolk sac tumors. Relapsed yolk sac tumors often showed pathological evidence of aggressiveness.

Keyword

Adolescent; Child, Preschool; Race relations; Testicular neoplasms

MeSH Terms

Adolescent
alpha-Fetoproteins
Child
Child, Preschool
Endodermal Sinus Tumor
Follow-Up Studies
Humans
Kinetics
Orchiectomy
Race Relations
Recurrence
Retrospective Studies
Teratoma
Testicular Neoplasms
Biomarkers, Tumor
alpha-Fetoproteins

Figure

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  FIG. 1 Comparison of preoperative alpha-fetoprotein (AFP) between patients with yolk sac tumors and those with teratomas.

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