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DR SHANDIP KUMAR SINHA
Pediatric Surgeon, Pediatric Urologist and Pediatric Laparoscopic Surgeon
Information for Parents
Testicular Tumor in Children
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What is this disease?
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Testicular tumors (TTs) are rare in children under 15, and account for 2–4% of all childhood cancers . They have two peaks of incidence in pediatric population: neonatal and puberty. An increased risk of TT is associated with cryptorchidism and gonadal dysgenesis. Testicular microlithiasis (TM) defined by five or more non-shadowing intratesticular echogenic calcific foci have shown association with testicular tumors in children , although the contribution of TM to the risk of malignancy is controversial and there is not any agreement for the management and monitoring of children with TM. Prepubertal-type teratomas (50%) and prepubertal yolk sac tumors (15%) are the most frequent TTs in children. Other tumors are epidermoid cyst (15%) and stromal tumor (Leydig cell and Sertoli cell), which account for approximately 10%.
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How it is diagnosed?
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TT diagnosis is based on ultrasonographic findings, clinical and endocrinological data and tumor marker levels as alpha-fetoprotein (AFP), beta-human gonadotropin chorionic (B-HCG), lactate dehydrogenase (LDH) or testosterone .Ultrasonography (US) is the imaging modality of choice for studying TTs with a 100 % sensitive and a negative-predictive value of almost 100%
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How it is treated?
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Treatment is surgical. It can be high inguinal orchidectomy or Testicular sparing surgery. Testicular sparing surgery should be used in children with a TT in which the normal testicular tissue seems salvageable on US and with normal tumor markers. Intraoperative frozen section examination can be applied to confirm pathological tumor as well as to justify conservative surgery. If abdominal lymph nodes , more than 2 cm of size are seen, chemotherapy may be necessary.
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When it should be operated?
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The tumor should be removed as soon as possible.
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Are there other alternative methods of treatment?
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Surgery is only modality available. Chemotherapy is needed in few cases,
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What all I need to know before my child surgery?
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Read “All you need to know before your child's surgery” information booklet in website.
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How is the surgery done?
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High Inguinal radical orchiectomy is procedure done . An incision is made in the groin and the entire tumor along with the testicle and the spermatic cord are removed.if testicular sparing surgery is considered, only tumor is removed and normal testes is not removed.
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Remarks
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For more details of surgery, contact your surgeon
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Related Photographs and videos
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Few photographs of steps done by me is given here for learning purposes
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