The management of testicular tumours in patients with undescended testicle in children
Objective To explore the clinical features,treatment methods,and prognosis of testicular tumors in children with undescended testicle.Methods A retrospective analysis was conducted on the clinical data of 13 children with undescended testicle and testicular tumors treated at the First Affiliated Hospital of Zhengzhou University from March 2013 to May 2022.The ages ranged from 7 months to 13 years,with an average age of(4.5±4.5)years.The main complaint was scrotal emptiness in 11 cases(with tumors on the cryptorchid side in 4 cases,and on the contralateral side in 7 cases),and testicular enlargement in 2 cases(both with contralateral tumors).Preoperative ultrasound examinations revealed testicular tumors in all cases.Preoperative serum alpha-fetoprotein(AFP)was significantly elevated in 2 cases,while the remaining 11 cases had normal AFP levels.All patients had normal human chorionic gonadotropin(β-HCG)levels.All patients underwent surgical treatment,with intraoperative frozen pathology performed.Based on frozen pathology results,2 cases with malignant tumors and 2 cases with benign tumors(with no normal testicular tissue seen intraoperatively)underwent radical orchiectomy,while the remaining 9 cases with benign tumors underwent testicular preservation surgery and cryptorchidism fixation.Results Postoperative pathology results were consistent with intraoperative frozen pathology results.The pathological diagnoses were 10 cases of mature teratomas,2 cases of yolk sac tumors,and 1 case of epidermoid cysts.All pathological stages were classified as stage Ⅰ.One case of yolk sac tumor received chemotherapy with bleomycin,cisplatin,and etoposide(BEP regimen).One case was lost to follow-up 6 months after surgery.Twelve cases were followed up for 1 to 9 years.Follow-up included chest X-rays and ultrasounds every 3 to 6 months,and abdominal CT or MRI scans every 6 months,with no local recurrence or distant metastasis observed.Conclusions Testicular tumors in children with undescended testicle are rare.The most common presenting symptom is scrotal emptiness,with contralateral testicular tumors being frequent in cryptorchid patients.The majority of testicular tumors in these patients are benign,with mature teratomas being the most common pathological type.Early diagnosis and timely surgical intervention result in a good prognosis.
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