Pediatric testicular tumors: 10 years of clinical approach at the Antiguo Hospital Civil de Guadalajara
DOI:
https://doi.org/10.56935/hij.v2i1.11Keywords:
Testicular tumor, Paratesticular, Tumor, Pediatric Patient, Tumor Markers , Clinical Presentation, Diagnosis, Treatment , Risk Facto, HistopathologyAbstract
Abstract. - Introduction: In recent decades, the prevalence of testicular cancer has increased. The prevalence of testicular cancer in children under 19 years of age worldwide represents the sixth position in terms of frequency. The estimated prevalence is 0.3-3.1, incidence 0.17-1.4 and mortality 0.02-0.1 per 100,000. Considering the increase in the prevalence of testicular cancer, we conducted this study with the intention of knowing the clinical characteristics, the diagnostic and therapeutic approach, as well as the incidence and mortality in our environment. Methods: A case series of pediatric patients attended from January 1, 2013 to January 1, 2023 at the Antiguo Hospital Civil de Guadalajara Fray Antonio Alcalde was carried out. Age, risk factors, clinical presentation, tumor markers (BHCG, AFP, LDH), imaging studies, therapeutic management, tumor size and histopathological study were reviewed. The data was collected by reviewing clinical records; these data were downloaded into the Office Excel program and transferred to SPSS version 25. Results: We analyzed the records of 11 pediatric patients who met the inclusion criteria, 4 patients had a testicular tumor and 7 patients had a paratesticular tumor, estimating an incidence of 0.15/100 000. The mean for age at diagnosis was 14 years with a deviation of 8 with respect to the mean, only 2 patients (18.18%) presented cryptorchidism as a risk factor, all patients presented increased testicular size at diagnosis, tumor markers were positive in 41.6% of the cases in which it was measured. Ultrasound was performed in all cases, the mean size of the masses was 3 cm, 1 patient presented benign histology, while 3 patients presented positivity to malignancy. Five orchiectomies were performed, one lumpectomy and five are still under follow-up and surveillance. Conclusion: testicular and paratesticular tumors are infrequent in pediatric age, nevertheless, understanding them is of great importance in order to make an early diagnosis and offer an individualized therapeutic approach, considering limiting radical orchiectomy to cases in which malignancy is suspected.
References
Alanee S, Shukla A. Paediatric testicular cancer: an updated review of incidence and conditional survival from the Surveillance, Epidemiology and End Results database. BJU Int. 2009;104(9):1280-3.
Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, et al. Guidelines on Testicular Cancer: 2015 Update. Eur Urol. 2015;68(6):1054-68.
Patrikidou A, Cazzaniga W, Berney D, et al. European Association of Urology Guidelines on Testicular Cancer: 2023 Update. Eur Urol. 2023;84(3):289-301.
International Agency for Research on Cancer. Cancer today. 2023.
Caballero Mora FJ, Muñoz Calvo MT, García Ros M, Rodríguez de Alarcón J, Fernández Pérez ML, Casco F, et al. Tumores testiculares y paratesticulares en la infancia y adolescencia. An Pediatr. 2013;78(1):6-13.
Ibarra Rodríguez M, Murcia Pascual F, Vázquez Rueda F, Lucio Rodríguez Md, Siu Uribe A, Ramnarine Sánchez S, et al. Cirugía conservadora de parénquima en tumores testiculares. Cir Pediátr. 2021;34(1):15-9.
Li Z, Zhang W, Song H, Sun N. Testis-Preserving Tumor Enucleation Is Applicable in Children with Immature Testicular Teratoma. Urol Int. 2021;105(1-2):27-30.
Sangüesa C, Veiga D, Llavador M, Serrano A. Testicular tumours in children: an approach to diagnosis and management with pathologic correlation. Insights Imaging. 2020;11(1):74.
Azizi M, Babakhouya A, Rkain M, Benajiba N. Case Report: The Paratesticular Rhabdomyosarcoma in Children. J Cancer Ther. 2021;12(06):358-64.
Bujons A, Caffaratti J, Pascual M, Angerri O, Garat JM, Villavicencio H. Tumores testiculares en la infancia. Actas Urol Esp. 2011;35(2).
Cassidy FH, Ishioka KM, McMahon CJ, Chu P, Sakamoto K, Lee KS, et al. MR Imaging of Scrotal Tumors and Pseudotumors. Radiographics. 2010;30(3):665-83.
Couture J, Bolduc S. A rare testicular solid mass in children: juvenile granulosa cell tumour of testis. Can Urol Assoc J. 2012;6(2):101-3.
Epifanio M, Baldissera M, Esteban FG, Baldisserotto M. Mature Testicular Teratoma in Children: Multifaceted Tumors on Ultrasound. Urology. 2014;83(1):195-8.
Fang C, Huang DY, Sidhu PS. Elastography of focal testicular lesions: current concepts and utility. Ultrasonography. 2019;38(4):302-10.
Cooper C. Prepubertal Testicular and Paratesticular Tumors. 2022.
Friend J, Barker A, Khosa J, Samnakay N. Benign scrotal masses in children – some new lessons learned. J Pediatr Surg. 2016;51(10):1737-42.
Goddi A, Sacchi A, Magistretti G, Almolla J, Salvadore M. Real-time tissue elastography for testicular lesion assessment. Eur Radiol. 2012;22(4):721-30.
Golub MS, Collman GW, Foster PM, Kimmel CA, Rajpert-De Meyts E, Reiter EO, et al. Public Health Implications of Altered Puberty Timing. Pediatrics. 2008;121 Suppl 3:S218-30.
Hatano T, Yoshino Y, Kawashima Y, Shirai H, Iizuka N, Miyazawa Y, et al. Case of gonadoblastoma in a 9‐year‐old boy without physical abnormalities. Int J Urol. 1999;6(3):164-6.
Hermann A-L, L’Herminé-Coulomb A, Irtan S, Audry G, Cardoen L, Brisse HJ, et al. Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review. Cancers (Basel). 2022;14(13):3180.
Instituto Mexicano del Seguro Social. Guía de Práctica Clínica Diagnóstico y Tratamiento del Tumor Maligno del Testículo en Todas las Edades. 2010.
Karmazyn B, Weatherly DL, Lehnert SJ, Cain MP, Fan R, Jennings SG, et al. Characteristics of testicular tumors in prepubertal children (age 5–12 years). J Pediatr Urol. 2018;14(3):259.e1-259.e6.
Bennani H, Ziouziou I, El Ghanmi J, Karmouni T, El Khader K, Koutani A, et al. Rhabdomyosarcome paratesticulaire (RMSP) multimétastatique: à propos d’un cas. Can Urol Assoc J. 2014;8(9-10):660.
Kusler KA, Poynter JN. International testicular cancer incidence rates in children, adolescents and young adults. Cancer Epidemiol. 2018;56:106-11.
Metcalfe PD, Farivar-Mohseni H, Farhat W, McLorie G, Khoury A, Bägli DJ. Pediatric Testicular Tumors: Contemporary Incidence and Efficacy of Testicular Preserving Surgery. J Urol. 2003;170(6):2412-6.
Mittal D, Agarwala S, Yadav DK, Pramanik DD, Sharma MC, Bagga D. Testicular Tumors in Undescended Testes in Children Below 5 y of Age. Indian J Pediatr. 2015;82(6):549-52.
O’Shea K, Tong A, Farrelly P, Craigie R, Cheesman E, Shukla R, et al. Management and outcome of paediatric testicular tumours – A 20 year experience. J Pediatr Surg. 2021;56(11):2032-6.
Paul PAM, Calton N, Arnestina S, Mammen KJ. Paratesticular tumors. A clinicopathological study from a single tertiary hospital in North India. Ann Diagn Pathol. 2021; 50:151658.
Romo Muñoz MI, Núñez Cerezo V, Dore Reyes M, Vilanova Sánchez A, González-Peramato P, López Pereira P, et al. Testicular tumours in children: Indications for testis-sparing surgery. An Pediatr (Engl Ed). 2018;88(5):253-8.
Sehgal M, Anand S, Dhua A, Yadav D, Arava S, Barwad A. Rare paratesticular masses in children. J Indian Assoc Pediatr Surg. 2021;26(2):117.
Song Q-D. Ultrasound Appearances of Pediatric Testicular Yolk Sac Tumors: Twenty-one Cases in a Single Institution. J Ultrasound Med. 2018;37(10):2457-63.
Stein R, Quaedackers J, Bhat NR, Dogan HS, Nijman RJM, Rawashdeh YF, et al. EAU-ESPU pediatric urology guidelines on testicular tumors in prepubertal boys. J Pediatr Urol. 2021;17(4):529-33.
Stephenson A, Eggener SE, Bass EB, Chelnick D, Daneshmand S, et al. Diagnosis and Treatment of Early Stage Testicular Cancer: AUA Guideline. J Urol. 2019;202(2):272-81.
Tallen G, Hernáiz Driever P, Degenhardt P, Henze G, Riebel T. High Reliability of Scrotal Ultrasonography in the Management of Childhood Primary Testicular Neoplasms. Klin Padiatr. 2011;223(3):131-7.
Trama A, Mallone S, Nicolai N, Necchi A, Schaapveld M, Gietema J, et al. Burden of testicular, paratesticular and extragonadal germ cell tumours in Europe. Eur J Cancer. 2012;48(2):159-69.
Volokhina YV, Oyoyo UE, Miller JH. Ultrasound demonstration of testicular microlithiasis in pediatric patients: is there an association with testicular germ cell tumors? Pediatr Radiol. 2014;44(1):50-5.
Wang X, Xu S, Tang D, Li M, Wu D, Huang Y. Prepubertal testicular and paratesticular tumors in China: A single-center experience over a 10-year period. J Pediatr Surg. 2012;47(8):1576-80.
Williamson SR, Delahunt B, Magi-Galluzzi C, et al. The World Health Organization 2016 classification of testicular germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017;70(3):335-46.
Woodward PJ, Sohaey R, O'Donoghue MJ, Green DE. From the Archives of the AFIP. RadioGraphics. 2002;22(1):189-216.
Downloads
Published
How to Cite
Issue
Section
Categories
License
Copyright (c) 2024 José Antonio Gutiérrez Ureña, Guillerno Yanowsky Reyes, Andrea Paola Ramos Mora, Zacnicté Corona, Carlos Guillermo Abascal Medina, Laura Olivia Montaño Ángeles, Julio Edgardo Flores Revilla and Jesús Antonio Aguilar Mata
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License 4.0 that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.