It is well known that testicular tumours in children occur in one of two peaks. Firstly, in the first four years of life where a third to half of these tumours are benign and secondly during puberty where there is increased risk of malignancy. But the pathology of testicular tumours between these peaks, i.e. 5-12 years, is not well known. That’s exactly what the authors of this paper have addressed. They hypothesised that because of the low level of testosterone at this time, the incidence of malignant tumours is very low and retrospectively compared malignancy risk of primary testicular tumours in children in the prepubertal period (5-12 years) with younger (0-4 years) and pubertal (13-18 years) children. They found that the most common tumour types in 5-12 years were epidermoid cyst (31.3%) and tumour mimics (37.5%). The prevalence of cystic tumours in 5-12 year olds was not significantly different compared with other age groups. They also studied the contralateral testicular volume and found that it was significantly different among groups. In children aged 13-18 years the mean tumour maximal diameter was significantly larger compared with children 5-12 years and all malignant tumours had contralateral testicular volume >4ml. They concluded that they found that preadolescent children between the ages of 5 and 12 years have distinctive characteristics compared with the other age groups. Most importantly, no malignant testicular tumours were found in this age group. About a third of the children presented with an incidental testicular mass. The testicular tumours were significantly smaller compared with those in children aged 13 -18 years. The authors therefore suggest more conservative treatment in this group of patients.

Characteristics of testicular tumors in prepubertal children (age 5-12 years).
Karmazyn B, Weatherly DL, Lehnert SJ, et al.
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Ravindar Anbarasan

Southampton Children’s Hospital.

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