eMedicine Specialties > Pediatrics: Surgery > Urology

Prepubertal Testicular and Paratesticular Tumors: Follow-up

Author: Christopher S Cooper, MD, FACS, FAAP, Professor of Urology, Director of Pediatric Urology, University of Iowa, Children's Hospital of Iowa; Associate Dean for Student Affairs and Curriculum, University of Iowa Carver College of Medicine
Coauthor(s): Brian L Gallagher, MD, Resident Physician, Department of Urology, University of Iowa Hospitals and Clinics
Contributor Information and Disclosures

Updated: Sep 29, 2009

Follow-up

Further Outpatient Care

  • The type of tumor determines the need for further evaluation and follow-up care (see Surgical Care).

Complications

  • Treatment-related complications include known short- and long-term effects of surgery, chemotherapy, and external-beam irradiation.
    • The effects include risk of infertility, hemorrhagic cystitis, and subsequent development of secondary malignancy.
    • Children should be counseled regarding these risks before treatment.
  • Long-term follow-up care is required.

Prognosis

  • The prognosis for patients with benign testicular lesions is excellent.
  • Even for patients with metastatic yolk-sac tumor, survival with chemotherapy is approximately 90%.
  • Patients with rhabdomyosarcoma have an overall survival rate of more than 70% when treated with multimodal therapy. Poor prognostic indicators include alveolar histology, age older than 7 years, unresectable retroperitoneal disease, and distant metastatic disease.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to diagnose

Special Concerns

  • Because some testicular tumors appear in association with a hydrocele, the physician must consider ultrasonography if a hydrocele prevents physical examination of the testicle.
 


More on Prepubertal Testicular and Paratesticular Tumors

Overview: Prepubertal Testicular and Paratesticular Tumors
Differential Diagnoses & Workup: Prepubertal Testicular and Paratesticular Tumors
Treatment & Medication: Prepubertal Testicular and Paratesticular Tumors
Follow-up: Prepubertal Testicular and Paratesticular Tumors
Multimedia: Prepubertal Testicular and Paratesticular Tumors
References
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References

  1. Metcalfe PD, Farivar-Mohseni H, Farhat W, McLorie G, Khoury A, Bagli DJ. Pediatric testicular tumors: contemporary incidence and efficacy of testicular preserving surgery. J Urol. Dec 2003;170(6 Pt 1):2412-5; discussion 2415-6. [Medline].

  2. Cooper CS, Snyder HM III. Pediatric genitourinary cancer. In: Nachtsheim DA, ed. Urological Oncology. Georgetown, TX: Landes Bioscience; 2005.

  3. Ross JH, Kay R. Prepubertal testis tumors. Rev Urol. 2004;6(1):11-8. [Medline].

  4. Thomas JC, Ross JH, Kay R. Stromal testis tumors in children: a report from the prepubertal testis tumor registry. J Urol. Dec 2001;166(6):2338-40. [Medline].

  5. Agarwal PK, Palmer JS. Testicular and paratesticular neoplasms in prepubertal males. J Urol. Sep 2006;176(3):875-81. [Medline].

  6. Ross JH, Rybicki L, Kay R. Clinical behavior and a contemporary management algorithm for prepubertal testis tumors: a summary of the Prepubertal Testis Tumor Registry. J Urol. Oct 2002;168(4 Pt 2):1675-8; discussion 1678-9. [Medline].

  7. Pohl HG, Shukla AR, Metcalf PD, Cilento BG, Retik AB, Bagli DJ. Prepubertal testis tumors: actual prevalence rate of histological types. J Urol. Dec 2004;172(6 Pt 1):2370-2. [Medline].

  8. Shukla AR, Huff DS, Canning DA, Filmer RB, Snyder HM 3rd, Carpintieri D. Juvenile granulosa cell tumor of the testis:: contemporary clinical management and pathological diagnosis. J Urol. May 2004;171(5):1900-2. [Medline].

  9. Richie JP, Steele GS. Neoplasms of the testis. In: Wein AJ, Kavoussi LR, Novick AC, Partin AW, Peters CA. eds. Campbell-Walsh Urology. 9th ed. Philadelphia: Saunders; 2007.

  10. Muller J, Ritzen EM, Ivarsson SA, Rajpert-De Meyts E, Norjavaara E, Skakkebaek NE. Management of males with 45,X/46,XY gonadal dysgenesis. Horm Res. 1999;52(1):11-4. [Medline].

  11. Wu HY, Snyder HM 3rd. Pediatric urologic oncology: bladder, prostate, testis. Urol Clin North Am. Aug 2004;31(3):619-27, xi. [Medline].

  12. Walsh TJ, Davies BJ, Croughan MS, Carroll PR, Turek PJ. Racial differences among boys with testicular germ cell tumors in the United States. J Urol. May 2008;179(5):1961-5. [Medline].

  13. Cushing B, Perlman EJ, Marina NM, Castleberry RP. Germ cell tumors. In: Pizzo PA, Poplack DG, eds. Principles and Practice of Pediatric Oncology. Philadelphia: Lippincott Williams & Wilkins; 2002.

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Further Reading

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Keywords

prepubertal testicular tumor, paratesticular tumor, cancer, neoplasms, yolk sac tumor, yolk-sac tumor teratoma, teratocarcinoma, seminoma, gonadal stromal tumor, juvenile granulosa cell tumor, juvenile granulosa-cell tumor, Leydig cell tumor, Leydig-cell tumor, Sertoli cell tumor, Sertoli-cell tumor, pediatric prepubertal testicular tumor, germ-cell tumor, embryonal carcinoma, teratoma, testis tumor, gynecomastia, congenital adrenal hyperplasia, gonadoblastoma, leukemia, lymphoma, rhabdomyosarcoma

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Contributor Information and Disclosures

Author

Christopher S Cooper, MD, FACS, FAAP, Professor of Urology, Director of Pediatric Urology, University of Iowa, Children's Hospital of Iowa; Associate Dean for Student Affairs and Curriculum, University of Iowa Carver College of Medicine
Christopher S Cooper, MD, FACS, FAAP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Urological Association, International Children's Continence Society, Phi Beta Kappa, Society for Basic Urologic Research, Society for Fetal Urology, and Society for Pediatric Urology
Disclosure: Nothing to disclose.

Coauthor(s)

Brian L Gallagher, MD, Resident Physician, Department of Urology, University of Iowa Hospitals and Clinics
Disclosure: Nothing to disclose.

Medical Editor

Bartley G Cilento, Jr, MD, Instructor, Department of Surgery, Division of Urology, Children's Hospital of Boston and Harvard Medical School
Bartley G Cilento, Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, and Massachusetts Medical Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Harry P Koo, MD, Chairman of Urology Division and Director of Pediatric Urology, Virginia Commonwealth University; Professor of Surgery, VCU School of Medicine, Medical College of Virginia; Director of Urology, Children's Hospital of Richmond
Harry P Koo, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, and American Urological Association
Disclosure: Nothing to disclose.

CME Editor

Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine
Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine
Disclosure: Baxter Honoraria Consulting

Chief Editor

Marc Cendron, MD, Associate Professor of Surgery, Harvard School of Medicine; Consulting Staff, Department of Urological Surgery, Children's Hospital Boston
Marc Cendron, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, European Society for Paediatric Urology, Johns Hopkins Medical and Surgical Association, New Hampshire Medical Society, Society for Fetal Urology, and Society for Pediatric Urology
Disclosure: Nothing to disclose.

 
 
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