TESTICULAR-TUMORS IN PREPUBERTAL CHILDREN

A clinical analysis was made of 556 prepubertal children with testis tumors. Germinal tumors comprised 76 per cent of this group, and the most common of these tumors was the yolk sac carcinoma. Although many appellations have been used to describe this tumor, experimental and clinical evidence support the use of this term. The over-all two-year survival was 72 per cent and was better in children less than two years of age. The tumor is distinctly different from the embryonal carcinoma of the adult. The role of lymphadenectomy needs to be reassessed in view of the low incidence of lymph node metastases and the propensity for pulmonary metastases. Chemotherapy appears to be of benefit. Tumor markers, particularly alpha-fetoprotein, may be of assistance in planning therapy. The other germinal tumor is the teratoma. This is a benign, nonmetastasizing disease in children and requires only orchiectomy. Nongerminal tumors comprised 24 per cent of tumors and require only orchiectomy. Sertoli cell tumors are rare, and there has been only one report of metastatic disease. Leydig cell tumors present with endocrine manifestations and are benign in children. They may be difficult to distinguish from tumors associated with congenital adrenal hyperplasia. Rhabdomyosarcomas should be treated with a combination of surgery, chemotherapy, and radiation. The over-all survival of 74 per cent for these patients indicates the benefits of aggressive therapy. © 1979.