Case series: Adult testicular dermoid tumours – mature teratoma or pre-pubertal teratoma?

Abstract

Adult testicular dermoid tumours are rare tumours with no reported potential for recurrent or metastatic spread. Despite this they are currently classified as mature teratoma and managed as if they have equivalent malignant potential. This report describes two cases of adult mature teratoma of dermoid type and questions the classification and pathogenesis of this disease. In one of the cases there was a clear history of a testicular lump arising pre-pubertally, raising the possibility that some adult dermoid tumours may in fact be pre-pubertal teratomas that have persisted into adulthood. Classification as a mature teratoma carries with it a follow-up regimen that includes numerous radiological investigations with their attendant radiation exposure. A positive histological diagnosis and separate classification of adult dermoid tumours would allay clinical fears of recurrence and metastasis and negate the need for repeated radiological investigations.

Testicular and paratesticular tumors and tumor-like lesions in the first 2 decades

“…70 It has been suggested that some may represent persistence of prepubertal teratomas into the postpubertal period. 71 Secondary malignant tumors are recognized if uncommon complication of postpubertal germ cell tumors, as evidenced by studies reporting rhabdomyosarcoma, myxoid liposarcoma, primitive neuroectodermal tumor, chondrosarcoma, melanotic neuroectodermal tumor, and carcinoid tumor in patients who were 12-19 years old. [72][73][74][75][76] However, we are aware of only one case where this occurred in a prepubertal testicular teratoma.…”

Cisto Desmóide Testicular – Relato De Caso E Revisão De Literatura

“…Os derivados da endoderme são células do epitélio gastrointestinal, respiratório e glândulas mucosas. Os elementos derivados da mesoderme incluem ossos, cartilagem e músculos (4,5). Há características que podem servir para o diagnóstico diferencial entre cisto dermóide e teratoma testicular, os teratomas testiculares maduros apresentam componentes sólidos e císticos em detrimento de material predominantemente cístico no cisto dermoide e a presença de pelo ou cabelo intralesional é típica do cisto dermoide, aparecendo em mais da metade dos casos (6).…”

Ten testicular trapdoors

“…One study of testicular tumours in prepubertal children found that 74% were benign 86 . Pure teratoma was the most common tumour present in 48% of cases, and, as suggested above, these may be equivalent to adult dermoid cysts 18 . Pure yolk sac tumours comprised 15%, epidermoid cysts 14% and sex‐cord stromal tumours 13% of cases.…”

“…However, recently a type of teratoma has been described with no associated ITGCNU, and it has been suggested that these lesions are benign, and are termed dermoid cysts 17 . As paediatric teratomas also lack ITGCNU, it has been suggested that these lesions are in fact paediatric lesions that have persisted to adult life 18 . Therefore, identification of ITGCNU becomes crucial for the correct follow‐up and classification.…”