Publication: Tumores testiculares y paratesticulares en la etapa prepuberal
Authors
Rojas-Ticona, J. ; Fernández-Ibieta, M. ; Nortes Cano, L. ; Girón Vallejo, Óscar ; Reyes Ríos, P. ; Martínez Castaño, I. ; Villamil, V. ; Ruiz Jiménez, J.I.
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Facultad de Medicina
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Publisher
Sociedad Española de Cirugía Pediátrica
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DOI
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info:eu-repo/semantics/article
Description
El presente trabajo fue presentado parcialmente como poster moderado en la XL Reunión de la Sociedad de Pediatría del Sureste de España, celebrado en Murcia en 2013 y como comunicación oral en el 53º Congreso de la Sociedad Española de Cirugía Pediátrica, celebrado en Cádiz los días 22 y 23 de mayo de 2014.
Abstract
Objetivos. Describir nuestra experiencia en tumores testiculares y paratesticulares en la etapa prepuberal, incidiendo sobre todo en su carácter de benignidad/malignidad y el tratamiento quirúrgico empleado. Material y Métodos. Revisión retrospectiva de todos los tumores testiculares en menores de 12 años, diagnosticados y tratados en nuestro ámbito clínico desde 1998 hasta 2015. Se recogieron datos sobre su forma de presentación, estudio y manejo. Resultados. 17 niños con tumores testiculares prepuberales fueron identificados. La presentación clínica como masa palpable testicular se dio en 12 casos (70,5%). De los niveles de marcadores tumorales (alfa-fetoproteína y βhCG), solo estuvo aumentada la alfa-fetoproteína en dos casos. En el estudio anatomopatológico, el 64,7% de los tumores fueron benignos (cinco teratomas maduros, cuatro tumores de células de Leydig, un teratoma inmaduro y un tumor de los cordones sexuales-estromal). Los tumores malignos fueron tres rabdomiosar comas (17,6%), dos tumores del saco vitelino (11,8%) y un linfoma de Burkitt (5,9%). La edad media de los benignos fue 5,9 años y de los malignos 2,9 años, (p=0,68). De las lesiones neoplásicas nueve fueron de estirpe no germinal (53%) y ocho germinales (47%). En el manejo quirúrgico se realizó tumorectomía en seis tumores benignos, orquidectomía en cinco tumores benignos y en todos los tumores malignos salvo el linfoma que sólo recibió quimioterapia. Conclusiones. Los tumores testiculares y paratesticulares primarios benignos son más frecuentes en la etapa prepuberal y en su tratamiento se acepta indicar cirugía conservadora por vía inguinal.
Objectives. To describe our experience in testicular and paratesticular tumors during the prepubertal stage, focusing especially on its character of benignity/malignancy and surgical treatment used. Material and Methods. Retrospective review of all testicular tumors in children under 12 years diagnosed and treated in our clinical setting from 1998-2015. Data on their presentation, study and management were collected. Results. 17 children with prepubertal testicular tumors were identified. The clinical presentation as palpable testicular mass occurred in 12 cases (70.5%). Levels of tumor markers (alpha-fetoprotein and βhCG) were only increased alpha-fetoprotein in two cases. In the histopathological study, 64.7% of the tumors were benign (five mature teratomas, four Leydig cells tumors, one immature teratoma and one sexual cords-stromal tumor). Malignant tumors were three rhabdomyosarcoma (17.6%), two yolk-sac tumors (11.8%) and one Burkitt lymphoma (5.9%). The mean age of benign was 5.9 years old and malignant 2.9 years old (p=0.68). From neoplastic lesions nine were non-germline (53%) and eight germline (47%). In the management testis-sparing surgery was performed in six benign tumors, and orchiectomy in five benign tumors and in all malignant tumors except lymphoma which received chemotherapy. Conclusions. Benign primary testicular and paratesticular tumors are more frequent in prepubertals and testis-sparing surgery is indicated by inguinal approach.
Objectives. To describe our experience in testicular and paratesticular tumors during the prepubertal stage, focusing especially on its character of benignity/malignancy and surgical treatment used. Material and Methods. Retrospective review of all testicular tumors in children under 12 years diagnosed and treated in our clinical setting from 1998-2015. Data on their presentation, study and management were collected. Results. 17 children with prepubertal testicular tumors were identified. The clinical presentation as palpable testicular mass occurred in 12 cases (70.5%). Levels of tumor markers (alpha-fetoprotein and βhCG) were only increased alpha-fetoprotein in two cases. In the histopathological study, 64.7% of the tumors were benign (five mature teratomas, four Leydig cells tumors, one immature teratoma and one sexual cords-stromal tumor). Malignant tumors were three rhabdomyosarcoma (17.6%), two yolk-sac tumors (11.8%) and one Burkitt lymphoma (5.9%). The mean age of benign was 5.9 years old and malignant 2.9 years old (p=0.68). From neoplastic lesions nine were non-germline (53%) and eight germline (47%). In the management testis-sparing surgery was performed in six benign tumors, and orchiectomy in five benign tumors and in all malignant tumors except lymphoma which received chemotherapy. Conclusions. Benign primary testicular and paratesticular tumors are more frequent in prepubertals and testis-sparing surgery is indicated by inguinal approach.
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Citation
Cir Pediatr 2015; 28: 74-80
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