[Germ-cell tumors of the testis in childhood]

Germinative-cell tumors are the most common tumors of the testis in children. For a period of 15 years (1975-1989) the authors have observed 12 children with these tumors. Leading symptoms in all children was a gradual painless enlargement of one testis; the symptomatic hydrocele may delay the correct diagnosis for several months. In young children the mothers noticed the testicular changes earlier, while in older children the diagnosis was delayed. Three quarters of the tumors were in the left testis, seldom in the right and still more seldom bilaterally. Diagnostic methods were applied mostly when metastases or recurrence were suspected; most common were computer tomography and lymphography. The most common benign testicular tumors were the mature teratomas and malignant--endodermal sinus tumors. The modern operative approach to these patients is emphasized: radical orchiectomy with pre- and postoperative determination of AMP levels, periodic control computer tomography and echography of the retroperitoneum and thorax with 2-year observation in stage I and modified lymphadenectomy in stage II. As a result of the complex surgical and oncologic therapy, the late results were good in 7 children, 2 died and 3 were lost from control.