Testicular and paratesticular involvement by metastatic neuroblastoma

BACKGROUND. Testicular and paratesticular involvement is a less familiar fe ature in neuroblastoma and its prognostic impact is unclear. METHODS. The records of 1076 male patients in the German cooperative neurob lastoma treatment trials were searched for patients with testicular or para testicular involvement. RESULTS. The authors found 11 children with paratesticular or testicular in volvement at the time of manifestation of the disease, 3 children with test icular involvement at the time of relapse, and 1 infant with testicular inv olvement at the time of progression of neuroblastoma from International Neu roblastoma Staging System (INSS) Stage 4S to Stage 4. In de novo disease, t he age of manifestation did not exceed 12 months. Two children had paratest icular involvement per continuitatem by growth of a primary tumor through t he inguinal channel. All others had distant primary tumor, Prognosis appear ed more favorable for infants (3 of 9 died) than for older children (5 of 6 died), for children with involvement of testes and < 10% involvement of bo ne marrow (2 of 8 died) than for children with other distant metastasis (6 of 7 died), and for children with intrascrotal involvement at first diagnos is (4 of 11 died) than for children with intrascrotal involvement during re lapse of the disease (all 4 children died). CONCLUSIONS, Paratesticular or testicular metastasis does not per se indica te unfavorable outcome and is compatible with INSS Stage 4S in infants. The age at diagnosis and the time of manifestation during disease contributed to the prognosis in those patients. (C) 2000 American Cancer Society.