EAU-ESPU pediatric urology guidelines on testicular tumors in prepubertal boys

Stein, Raimund; Quaedackers, Josine; Bhat, Nikita R.; Doğan, Hasan Serkan; Nijman, Rien J.M.; Rawashdeh, Yazan F.; Sılay, Mesrur Selçuk; Hoen, Lisette A. ’t; Tekgül, Serdar; Radmayr, Christian; Bogaert, Guy

doi:10.1016/j.jpurol.2021.06.006

Cited by 18 publications

(21 citation statements)

References 48 publications

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“…The incidence of prepubertal testicular tumors peaks in the first three years of life [10]. As compared with yolk-sac tumors, teratomas usually develop in younger children, with a median age of approximately 8 to 13 months and 16 to 17 months, respectively [3,7]. Among prepubertal testicular malignancies, the 5-year relative survival is 97% for children with localized tumors and 73% for those with distant disease [11].…”

Section: Epidemiology Of Pediatric Testicular Tumorsmentioning

confidence: 99%

“…BHCG is elevated in choriocarcinomas, embryonal carcinomas or seminomas, which are extremely rare in prepubertal boys but could be seen in adolescents. Thus, it is not useful in the diagnostic work-up of prepubertal boys with a testicular tumor but is useful in adolescents presenting a testicular mass [3]. Lactate dehydrogenase is also useful because high levels are associated with bulky disease and increasing levels after therapy may signify disease recurrence.…”

Section: Epidemiology Of Pediatric Testicular Tumorsmentioning

confidence: 99%

“…However, intra-operative frozen section analysis seems to more accurately predict the pathological diagnosis [21], which suggests that it should be systematically performed during TSS to confirm the benign diagnosis and that microscopically margin-negative resection has been achieved. In the case of microscopic positive margins in a malignant or potentially malignant tumor, orchidectomy should be performed [3]. Orchidectomy with the inguinal approach should be considered if normal testicular parenchyma is no longer detectable on preoperatively high-resolution US and/or with AFP level > 100 ng/mL in a child > 12 months, considering high suspicion of yolk-sac tumor [3], or with AFP level > 23 ng/mL in a child < 8 months with a tumor > 2.5 cm because of increased frequency of immature teratomas [22].…”

Section: Management Of Pediatric Testicular Tumorsmentioning

confidence: 99%

“…In the case of microscopic positive margins in a malignant or potentially malignant tumor, orchidectomy should be performed [3]. Orchidectomy with the inguinal approach should be considered if normal testicular parenchyma is no longer detectable on preoperatively high-resolution US and/or with AFP level > 100 ng/mL in a child > 12 months, considering high suspicion of yolk-sac tumor [3], or with AFP level > 23 ng/mL in a child < 8 months with a tumor > 2.5 cm because of increased frequency of immature teratomas [22].…”

Section: Management Of Pediatric Testicular Tumorsmentioning

confidence: 99%

“…Imaging also plays an important role in the post-operative follow-up, especially to depict recurrence in the contralateral testicle or in distant sites in case of malignant tumors treated with orchidectomy. It also helps to evaluate the volume of residual normal testicular tissue after TSS which could be an indicator of fertility [3].…”

Section: Introductionmentioning

confidence: 99%

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Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review

Hermann

L’Herminé-Coulomb

Irtan

et al. 2022

Cancers

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Pre- and post-pubertal testicular tumors are two distinct entities in terms of epidemiology, diagnosis and treatment. Most pre-pubertal tumors are benign; the most frequent are teratomas, and the most common malignant tumors are yolk-sac tumors. Post-pubertal tumors are similar to those found in adults and are more likely to be malignant. Imaging plays a pivotal role in the diagnosis, staging and follow-up. The appearance on ultrasonography (US) is especially helpful to differentiate benign lesions that could be candidates for testis-sparing surgery from malignant ones that require radical orchidectomy. Some specific imaging patterns are described for benign lesions: epidermoid cysts, mature cystic teratomas and Leydig-cell tumors. Benign tumors tend to be well-circumscribed, with decreased Doppler flow on US, but malignancy should be suspected when US shows an inhomogeneous, not-well-described lesion with internal blood flow. Imaging features should always be interpreted in combination with clinical and biological data including serum levels of tumor markers and even intra-operative frozen sections in case of conservative surgery to raise any concerns of malignity. This review provides an overview of imaging features of the most frequent testicular and para-testicular tumor types in children and the value of imaging in disease staging and monitoring children with testicular tumors or risk factors for testicular tumors.

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Section: Epidemiology Of Pediatric Testicular Tumorsmentioning

confidence: 99%

Section: Epidemiology Of Pediatric Testicular Tumorsmentioning

confidence: 99%

Section: Management Of Pediatric Testicular Tumorsmentioning

confidence: 99%

Section: Management Of Pediatric Testicular Tumorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review

Hermann

L’Herminé-Coulomb

Irtan

et al. 2022

Cancers

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Versorgungswirklichkeit ausgewählter kinderurologischer Eingriffe in Deutschland von 2006 bis 2019

Maier

Ebert

Baunacke

et al. 2021

Urologe

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Zusammenfassung Hintergrund Die konservative und chirurgische Behandlung von Kindern ist in der urologischen Facharztweiterbildung fest verankert und stellt eine Kernkompetenz der urologischen Versorgung dar. Berufspolitisch wird seit vielen Jahren ein zunehmender Verlust dieses Schwerpunkts befürchtet. Ziel dieser Studie ist es, reale Fallzahlen und eine mögliche Dynamik in der Verteilung kinderurologischer Eingriffe auf die Fachabteilungen für Urologie und Kinderchirurgie in Deutschland zu prüfen. Material und Methoden Als Index-Eingriffe definierten wir Operationen des Hodenhochstands, der Hypospadie und des vesikoureteralen Refluxes (VUR). Mithilfe der Software reimbursement.INFO (RI Innovation GmbH, Hürth) werteten wir die öffentlich zugänglichen Qualitätsberichtsdaten der deutschen Krankenhäuser von 2006 bis 2019 aus und wiesen sie den entsprechenden Fachrichtungen zu. Ergebnisse Die Orchidopexie erfolgt häufiger in der Urologie, wohingegen die Hypospadiekorrektur und die operative Therapie des VUR häufiger in der Kinderchirurgie durchgeführt werden. Anteilig zeigte sich für die Orchidopexie und die operative Refluxtherapie keine relevante Verschiebung zwischen urologischen und kinderchirurgischen Kliniken im Untersuchungszeitraum. Bei den Hypospadiekorrekturen nimmt der Anteil der Operationen in kinderchirurgischen Einheiten zu (p < 0,0001). In der Kinderchirurgie erfolgen 84–93 % der analysierten Eingriffe in High-volume-Abteilungen während dieser Anteil in der Urologie bei 56–73 % liegt. Insbesondere die operative Refluxtherapie in der Urologie erfolgt zu einem hohen Anteil als Gelegenheitseingriff (30 % „very low volume“). Schlussfolgerung Die Qualitätsberichtsdaten ermöglichen die Erfassung der Fallzahlen und die Analyse der Verteilung zwischen Urologie und Kinderchirurgie in Deutschland. Dabei ist für die Hypospadiekorrektur eine relevante Verschiebung in Richtung der Kinderchirurgie zu beobachten. Die Ursachen und möglichen berufspolitischen Konsequenzen dieser ersten Erhebung sind komplex und bedürfen weiterer Analysen.

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Los factores causantes del acortamiento de pene después de la cirugía con plicatura en pacientes con incurvación peneana congénita

Sahin¹,

Yeşildal

2023

Actas Urológicas Españolas

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EAU-ESPU pediatric urology guidelines on testicular tumors in prepubertal boys

Cited by 18 publications

References 48 publications

Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review

Imaging of Pediatric Testicular and Para-Testicular Tumors: A Pictural Review

Versorgungswirklichkeit ausgewählter kinderurologischer Eingriffe in Deutschland von 2006 bis 2019

Los factores causantes del acortamiento de pene después de la cirugía con plicatura en pacientes con incurvación peneana congénita

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