Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 357-361, July 2008

Prepubertal Testicular Germ Cell Tumors: 25-year Experience in Taipei Veterans General Hospital

  • Yin-Shen Chen

      Affiliations

    • Division of Urology, Department of Surgery, Taipei Veterans General Hospital, and Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Junne-Yih Kuo

      Affiliations

    • Division of Urology, Department of Surgery, Taipei Veterans General Hospital, and Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Junne-Yih Kuo, Division of Urology, Department of Surgery, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C
    • ,
  • Tai-Wai Chin

      Affiliations

    • Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, and Department of Surgery, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Chou-Fu Wei

      Affiliations

    • Division of Pediatric Surgery, Department of Surgery, Taipei Veterans General Hospital, and Department of Surgery, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Kuang-Kuo Chen

      Affiliations

    • Division of Urology, Department of Surgery, Taipei Veterans General Hospital, and Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Alex T.L. Lin

      Affiliations

    • Division of Urology, Department of Surgery, Taipei Veterans General Hospital, and Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Luke S. Chang

      Affiliations

    • Division of Urology, Department of Surgery, Taipei Veterans General Hospital, and Department of Urology, National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 23 July 2007; accepted 28 April 2008.

Article Outline

Background

Due to the rarity of testicular tumors in the prepubertal population, adequate information about their biological course is difficult to document well in a single institution. The purpose of this study was to focus on prepubertal males in an attempt to evaluate clinical features and optimal management among various testicular germ cell tumors with long-term follow-up.

Methods

We retrospectively reviewed the records of children younger than 12 years of age with primary testicular germ cell tumors between February 1981 and December 2005 at Taipei Veterans General Hospital. Thirty-four children were diagnosed with adequate clinical and pathologic data. The stage of the disease was determined according to the staging system used by the Children's Oncology Group. Mean follow-up time was 139 months (range, 2–283 months).

Results

All of the 34 prepubertal patients were diagnosed initially with a painless scrotal mass. The mean age of the patients at diagnosis ranged from 6 months to 84 months (mean, 20.5 months). All patients underwent radical orchiectomy as an initial treatment. Twenty-nine (85.3%) patients had yolk sac tumors, and 5 (14.7%) had mature teratomas. Of the 29 patients with yolk sac tumor, 26 (89.7%) were diagnosed as stage I, 1 (3.4%) as stage III, and 2 (7.0%) as stage IV. Five (19.2%) of the 26 stage I yolk sac tumors progressed to metastasis after radical orchiectomy, and all of these 5 patients later received chemotherapy. One patient initially with stage III yolk sac tumor and 2 patients with stage IV yolk sac tumor were also treated with chemotherapy. Eventually, 1 patient with stage IV yolk sac tumor died due to tumor pro-gression; the remaining 28 patients with yolk sac tumor all survived without tumor relapse after appropriate treatment. In the 5 patients with teratomas, there was no tumor relapse after radical orchiectomy with a mean follow-up time of 139.1 months. The 5-year survival rates for yolk sac tumor and teratomas were 96.5% and 100%, respectively.

Conclusion

The most common prepubertal malignant testicular tumor is yolk sac tumor, and the most common benign testicular tumor is teratoma. Children with testicular germ cell tumors have excellent long-term survival rates after appropriate treatment.

Key Words:  prepubertal testicular tumor , testicular teratoma , testicular yolk sac tumor

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PII: S1726-4901(08)70139-4

doi:10.1016/S1726-4901(08)70139-4

Journal of the Chinese Medical Association
Volume 71, Issue 7 , Pages 357-361, July 2008

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