Testicular and paratesticular tumours in children: 30 years' experience

Background: Testicular or paratesticular rumours in children are rare, maki ng it difficult to achieve the best management for these life-threatening d iseases. The aim of this study is to review patients during a 30-year perio d with these rumours and assess clinical aspects to improve management. Methods: The records of 68 patients from 1967 to 1996 were reviewed with re spect to age at diagnosis, affected sites, presentation, clinical diagnosis , operation, pathology and prognosis. Results: The most common presentation was a painless scrotal mass (84%). Th e most common testicular tumour was mature teratoma (n = 27) followed by yo lk sac tumour (n = 17). Thirteen patients had paratesticular rhabdomyosarco ma. Two teratocarcinomas, three leydig cell tumours, two sertoli cell tumou rs, one granulosa cell tumour, one fibroma, one gonadoblastoma, and one sec ondary tumour from acute myeloid leukaemia were found also. Testis-sparing surgery was performed in 21 of 33 patients with benign rumours (27 teratoma , three leydig cell tumours, two sertoli cell rumours, one fibroma), which caused no recurrence. Only two patients with rhabdomyosarcoma and one with mixed germ cell tumour died of their disease. Conclusion: Recent combined therapy with surgery and chemotherapy against p rimary testicular and paratesticular tumours has improved prognosis. Testis -sparing surgery should be considered for benign tumours.