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Benign scrotal masses in children - some new lessons learned

Jikol Friend1, Andrew Barker1, Japinder Khosa1

  • 1Departments of Pediatric General Surgery, Princess Margaret Hospital, Western Australia, Australia.

Journal of Pediatric Surgery
|August 26, 2016
PubMed

Insights

Testicular-sparing surgery (TSS) is often used for benign testicular masses in children. This study reviewed outcomes, noting successful TSS in seven of eleven pre-pubertal males, with unique findings including Leydig cell hyperplasia and testicular regrowth after cyst removal.

Area of Science:

  • Pediatric Urology
  • Surgical Oncology
  • Endocrinology

Background:

  • Benign intratesticular masses are common in pre-pubertal males, often favoring testicular-sparing surgery (TSS).
  • Understanding outcomes of these procedures is crucial for pediatric surgical management.

Purpose of the Study:

  • To review the outcomes of benign testicular lumps in children treated at a tertiary pediatric center over 7.5 years.
  • To evaluate the efficacy and complications of testicular-sparing surgery (TSS) in pediatric patients.

Main Methods:

  • A retrospective review of pediatric benign testicular lesions was conducted from January 2008 to June 2015.
  • Data analysis focused on patient demographics, lesion types, surgical interventions, and outcomes.

Main Results:

  • Twelve benign intratesticular tumors were identified, primarily in pre-pubertal males (11 cases).
  • Common diagnoses included teratomas, epidermoid cysts, and Leydig cell hyperplasia.
  • Testicular-sparing surgery (TSS) was attempted in 11 pre-pubertal cases, with successful outcomes in seven; notable findings included testicular reconstitution after large cyst removal and one case of epidermoid cyst recurrence.

Conclusions:

  • This series highlights Leydig cell hyperplasia presenting with unilateral precocious puberty, a novel finding.
  • Evidence suggests testicular regeneration is possible after TSS for large intrasesticular cysts.
  • Recurrence of epidermoid cysts following TSS was observed, indicating the need for vigilant follow-up.
Abstract

Keywords:
BenignPediatricsTesticular sparing surgeryTesticular tumor

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