[Diagnosis and treatment of yolk sac tumor of the testis with hydrocele in children: report of 7 cases]

Zhonghua Nan Ke Xue. 2013 Nov;19(11):1007-10.
[Article in Chinese]

Abstract

Objective: To study the clinical characteristics of yolk sac tumor of the testis with concomitant testicular hydrocele in children and the association between the two conditions in order to improve the diagnosis and treatment of the disease.

Methods: We retrospectively analyzed the clinical data of 7 cases of stage-I yolk sac tumor of the testis with concomitant testicular hydrocele. The patients ranged in age from 6 to 14 (mean 11) months. As treatment, we performed radical high spermatic cord orchiectomy after diagnosis established on intraoperative frozen sections, and conducted follow-up visits by medical examination, serum alpha-fetoprotein (AFP) detection, chest X-ray, ultrasonography and CT for 3-41 (mean 17) months, every month in the first year, every 3 months in the second year and every 6 months in the third year after surgery.

Results: Postoperative pathology confirmed yolk sac tumor in all the cases, with negative incisal margin. The level of serum AFP were decreased to normal in 6 cases within 1 month after surgery, all diagnosed as at stage I, and cured without chemotherapy. The other 1 case, with the serum AFP level of 116 microg/L at 1 month after operation, was diagnosed as at stage II and received PVC chemotherapy, but lost to follow-up at 3 months post-operatively.

Conclusion: Yolk sac tumor of the testis with concomitant testicular hydrocele is easily misdiagnosed in children. Ultrasonography is necessitated as routine examination in its diagnosis. Radical high spermatic cord orchiectomy can be performed for patients in stage I, and chemotherapy should follow for those in stage II. Its prognosis is similar to that of other yolk sac tumors. Hitherto, there has been no evidence for a definitive correlation between yolk sac tumor of the testis and hydrocele in children.

MeSH terms

  • Endodermal Sinus Tumor / diagnosis
  • Endodermal Sinus Tumor / diagnostic imaging
  • Endodermal Sinus Tumor / surgery*
  • Humans
  • Infant
  • Male
  • Orchiectomy
  • Retrospective Studies
  • Spermatic Cord / surgery
  • Testicular Hydrocele / diagnosis
  • Testicular Hydrocele / diagnostic imaging
  • Testicular Hydrocele / surgery*
  • Testicular Neoplasms / diagnosis
  • Testicular Neoplasms / diagnostic imaging
  • Testicular Neoplasms / surgery*
  • Testis / pathology
  • Ultrasonography
  • alpha-Fetoproteins / metabolism

Substances

  • alpha-Fetoproteins