Prepubertal testicular tumours and efficacy of testicular preserving surgery

OBJECTIVE • To report our experience of testicular tumours in children aged ≤13 years, including our experience with testis-sparing surgery. PATIENTS AND METHODS • A retrospective study was performed of 15 patients with testicular tumours aged ≤13 years who presented at our centre between 1984 and 2008. The use of testis-preserving surgery according to indication was investigated and outcomes were recorded. RESULTS • The clinical presentation was increased testicular size with a palpable mass in 80% of the cases. All 15 patients underwent surgery. The tumour was benign in 12 (80%) patients and malignant in three (20%) patients. • Organ-preserving surgery was planned and achieved in 11 patients (73%). • Pathology of the tumourectomy specimens disclosed benign tumours in all cases: four epidermoid cysts, two teratomas, one juvenile granulosa cell tumour, one haemangioma, one lipoma, one fibrous hamartoma and one splenogonadal fusion. • In four patients who underwent radical orchiectomy, pathology identified one yolk sac tumour (stage I), two mixed germ cell tumours and one gonadoblastoma. CONCLUSIONS • In children, most testicular tumours are benign, especially before puberty. A testis-sparing procedure should be performed in children with a palpable testicular mass and negative tumour markers. • The lesion, however, should be thoroughly excised to avoid recurrences.