High Reliability of Scrotal Ultrasonography in the Management of Childhood Primary Testicular Neoplasms

Abstract

Scrotal US is highly sensitive for the detection of childhood primary intratesticular tumors and, when combined with clinical data, highly reliable for differential diagnosis. It may help clinicians to decide when to opt for testis-sparing surgery.

Current urologic care for testicular germ cell tumors in pediatric and adolescent patients

“…At a minimum, serum tumor markers (AFP, β-hCG, and lactate dehydrogenase [LDH]) should be drawn and a scrotal ultrasound performed. Duplex Doppler ultrasound can reliably detect testicular neoplasms in nearly 100% of cases, differentiate between testicular and paratesticular tumors, and assess the status of the contralateral testicle [32]. Benign tumors tend to be well circumscribed with decreased Doppler flow and some have characteristic features.…”

“…Epidermoid cysts exhibit well-defined features containing echogenic debris and teratomas often have a multicystic appearance. YSTs, contrarily, tend to be more solid in appearance, homogenous, and hypoechoic [13,32].…”

The role of testis-sparing surgery in children and adolescents with testicular tumors

“…Scrotal ultrasound is useful in further characterization of the mass and whether it is indeed a primary testis tumor vs. an extratesticular lesion. Although it cannot reliably distinguish between malignant and benign neoplasms, certain features on ultrasound may be suggestive of specific histology, with some authors reporting the accuracy of histologic diagnosis by ultrasound approaching 75%, when combined with clinical symptoms [20,21]. Hypoechoic cystic areas with adjacent hyperechoic areas within a well-circumscribed lesion, surrounded by normal testicular parenchyma, are characteristic of teratoma [15].…”

Tumorregister und Realität - Differenzialdiagnose von Hodentumoren im Kindesalter - Übersicht mit eigenem Patientengut

“…Die seltenen juvenilen Granulosazelltumoren können in bis zu 20 % mit strukturellen Abnormalitäten des Y-Chromosoms oder einer Mosaikbildung, sowie sexuellen Differenzierungsstörungen vergesellschaftet sein [24]. Kindliche Hodentumoren werden dennoch klinisch in bis zu 80 % präoperativ aufgrund des raumfordernden, verhärteten Tastbefundes korrekt vermutet [5,10]. Den verbleibenden Rest verkomplizieren koinzident auftretende oder sekundär entstandene Hydrozelen [5].…”