Multicenter retrospective study on benign testicular tumors in children: save as much as you can……please
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jun 2023 · 1 min read
In brief
In brief
This multicenter Latin American study of 62 pediatric benign testicular tumors demonstrates that preoperative ultrasound combined with intraoperative frozen section biopsy enables safe testis-sparing surgery in 81% of cases. The approach achieved 98% diagnostic accuracy with no testicular atrophy during follow-up, supporting organ preservation over routine orchiectomy.
Written by the GCMD Library team from the article.
Background: Testicular tumors (TT) are infrequent in pediatric patients, representing 1% of pediatric solid tumors; benign testicular tumors (BTT) are the most common. We present a multicenter study aiming to describe the incidence, histology and surgical technique of BTT, with special emphasis on which approach could present better outcomes.
Methods: The records of pediatric patients diagnosed with BTT between 2005 and 2020 from 8 centers in 5 different countries in Latin-America, were reviewed.
Results: Sixty two BTTs were identified. 73% tumors presented as a testicular mass, and 97% underwent testicular ultrasound as the initial imaging study, all of them had findings suggestive of a benign tumor. 87% had preoperative tumor markers (AFP and BHCG). In 66%, an intraoperative biopsy was done and 98% of the intraoperative biopsies were concordant with the final pathology report. Tumorectomy was performed in 81% of patients and total orchiectomy in the remaining 19%. Six percentage of patients underwent a subsequent orchiectomy. Mean follow-up was 39 months (1-278 months) where no cases of atrophy were observed clinically or on ultrasound. Fertility was not evaluated in this series.
Conclusions: Proper management of BTTs is essential to avoid unnecessary orchiectomies. Preoperative ultrasound associated with intraoperative biopsy seems accurate in identifying benign pathology, thus enabling conservative testicular surgery with safety margins. Based on this multicenter series, we suggest performing an intraoperative biopsy with subsequent tumorectomy preserving healthy testicular tissue in BTT.
DOI: 10.1007/s00383-023-05444-8