Characterization of prepubertal testicular masses: multicenter case series

Characterization of prepubertal testicular masses: multicenter case series

Ana Ma. Ortiz-Zableh 1 , Mariana Echeverry-Gaviria 2 , Karen B. García-Peña 2 , Héctor M. Rodríguez 3 , Johanna Ovalle-Díaz 4 , Emilio Marín 5 , Víctor H. Figueroa-Arenas 6

1 Servicio de Urología, Centro Urológico FOSCAL, Colombia; 2 Servicio de Urología, Universidad Militar Nueva Granada, Bogotá, Colombia; 3 Servicio de Urología, Centro Urológico FOSCAL, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia; 4 Departamento de Urología, Universidad Militar Nueva Granada, Bogotá, Colombia; 5 Departamento de Urología, Clínica San Luis, Bucaramanga, Colombia; 6 Departamento de Urología, Clínica FOSCAL, Universidad Autónoma de Bucaramanga, Bucaramanga, Colombia

*Correspondence: Ana Ma. Ortiz-Zableh. Email: aortiz779@unab.edu.co

Abstract

Objective: Prepubertal testicular tumors represent less than 1% of tumors. These are usually germ cell tumors (benign teratomas and yolk sac tumors), and epidermoid cysts (benign). Partial orchiectomy is considered the standard management, allowing preservation of testicular function, with low recurrence rate. The aim of this study is to characterize the most frequent tumor types in the population of prepubertal patients diagnosed with testicular masses.

Method: Observational case series study of prepubertal patients with diagnosis of testicular masses submitted to radical orchiectomy, partial or testicular biopsy, between 2014 and 2020 in three Colombian institutions.

Results: Twenty-one patients were identified; two had a history of lymphoproliferative neoplasia. Yolk sac tumor was identified as the most frequent testicular tumor. Nine underwent partial orchiectomy based on freeze biopsy findings. Three patients received adjuvant chemotherapy based on histopathologic outcome. The median follow-up was 26 months. One patient required retroperitoneal lymphadenectomy and lobectomy for metastatic involvement (currently disease free); one patient died of metastatic involvement.

Conclusions: We identified yolk sac tumor as the most frequent testicular tumor. Freezing biopsy is a reliable tool for diagnosis, which allows guiding the surgical approach towards a conservative management, avoiding radical orchiectomy in prepubertal patients, preserving aesthetics, fertility, and hormonal function in the long term.

Keywords: Testicular neoplasms; Pediatrics; Urology; Puberty; Orchiectomy

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