Value of simple tumour excision for benign testicular tumours in children.

From 1984 to 1999, the authors observed 18 intratesticular tumours, 13 of w hich corresponded to benign lesions. The objective of this study is to defi ne preoperative and intraoperative criteria of benign lesions in order to a llow conservative management (simple excision or enucleation) and to analys e the results of this treatment. The 13 boys of this series were between th e ages of 5 months and 14 years (mean: 7.1 years). The lesion presented as scrotal swelling in 12 cases and gynaecomastia in 1 case. Tumour markers (a lphafoetoprotein, beta HCG) were at the limit of normal for age. Ultrasonog raphy was performed in every case. In each case, treatment consisted of pri mary exposure of the pedicle with clamping then exteriorization and macrosc opic examination of the lesion. Frozen section examination was performed in Ii cases. Treatment consisted of 9 enucleations and 4 orchidectomies. The final histology concluded on epidermoid cyst or simplified teratoma with ex clusively ectodermal development in 4 cases, multi-differentiated teratoma in 2 cases, sex cord tumour in 2 cases, simple cyst in 2 cases, rete testis dysplasia in 1 case, cavernous haemangioma in 1 case, and vestigial cyst i n 1 case. There was no discordance between the final histological examinati on and the frozen section examination. The mean follow-up is 4.4 years. No secondary atrophy and no local or distant recurrence was observed in the 9 cases of enucleation. In conclusion, testicular tumours are often benign in children. Selection based on a body of clinical, laboratory, radiological and frozen section histological evidence should allow carcinologically safe conservative surgery with an aesthetic, psychological and Functional benef it: for the child.