[Tumors of the testis in children]

Tumours of the testicle are rare in children (about one case in 100,000 male children). Their histological type usually leads to favourable outcome. We report here our series of 12 cases together with an analysis of the large published series in order to review the prognosis and therapeutic indications which depend on the histology. The most frequent intratesticular tumours in the child are nonseminoma malignant germ cell tumours. At birth the tumour is usually a mature or mixed teratoma. Between the ages of 1 and 3 years the most frequently observed tumour arises from the vitelline sac representing about 50% of all tumours of the testicle in the child. From 3 years to puberty, paratesticular rhabdomyocarsomas and Leydig cell tumours are the most frequently encountered. Finally, at puberty, tumours of the testicle are the same as those observed in the adult, notably seminomas which are not observed before puberty. Other tumours occur only exceptionally. Orchiectomy after ligature of the spermatic cord is the usual treatment. Complementary chemotherapy and node dissection are not required as first intention therapy when the tumour is well localized (complete exeresis, no lymph node invasion, no pulmonary metastasis), but are reserved for relapse or residual tumours revealed by a secondary rise in alpha foetoprotein levels or by extension from the initial site. A present, in 80% of the patients with localized tumours, outcome is favourable without lymph node dissection or chemotherapy. The three-year survival rate is approximately 90%.