David Semjén, András Farkas, Endre Kalman, Balint Kaszas, Árpad Kovács, Csaba Pusztai, Karoly Szuhai, Tamás Tornóczky
Faculty of Medicine, Department of Pathology 2nd Diagnostic Laboratory, Rákóczi u 2, PÉCS, H-7624, Hungary.
Faculty of Medicine, Department of Paediatrics, Pécs University, József Attila u.7, Pécs, H-7623, Hungary.
Pathol Oncol Res. 2017 Jul;23(3):513-517. doi: 10.1007/s12253-016-0120-3. Epub 2016 Oct 28.
Benign testicular teratomas are always thought to be pediatric neoplasms and previously all the teratoid tumors in the adult testis regarded as malignant. Recently, three publications reported benign testicular teratomas in adulthood and the latest WHO classification refers them as "prepubertal type of teratomas" which rarely appear in adulthood. These neoplasms behave benign and seemingly analogous independently whether they appear in pre- or postpubertal patients. The aim of our study was to investigate the frequency of benign testicular teratomas both in children and adults. 593 cases of testicular neoplasms were found in a period of 17 years ranging from 1998 to 2014 in the archive of our department (Department of Pathology, Medical Center, Pécs University). 543 cases diagnosed as germ cell tumor which have all been further evaluated in conjunction with the clinical data available. Of all germ cell tumor cases 14 (2.5 %) were pure teratomas. Ten out of 14 were the WHO-defined "conventional" teratoma, 4 of the 14 were the "benign or the so called prepubertal type" from which three occurred in adult patients. Only one of the 14 occurred in childhood, indicating that benign prepubertal type teratomas -which are regarded generally as childhood tumors- are more frequently detected in adults than in children. Benign adult testicular teratomas comprised 21 % of all pure teratoma cases in our series. Practicioners in the field have to be aware of its existence also in adulthood to avoid overtreatment and not to expose their patients to unnecessary chemotherapy, retroperitoneal lymphadenectomy (RLA) and the potential complications of these interventions.
良性睾丸畸胎瘤一直被认为是儿童肿瘤，以前所有成年睾丸中的类畸胎瘤都被视为恶性肿瘤。最近，有三篇文献报道了成年期的良性睾丸畸胎瘤，最新的世界卫生组织分类将它们称为“青春期前型畸胎瘤”，这种肿瘤在成年期很少出现。这些肿瘤无论出现在青春期前还是青春期后的患者中，其行为都表现为良性且看似独立相似。我们研究的目的是调查儿童和成人中良性睾丸畸胎瘤的发生率。在我们科室（佩奇大学医学中心病理科）1998年至2014年的17年档案中发现了593例睾丸肿瘤病例。543例被诊断为生殖细胞肿瘤，并结合现有临床资料进行了进一步评估。在所有生殖细胞肿瘤病例中，14例（2.5%）为纯畸胎瘤。14例中有10例是世界卫生组织定义的“传统”畸胎瘤，14例中有4例是“良性或所谓青春期前型”，其中3例发生在成年患者中。14例中只有1例发生在儿童期，这表明通常被视为儿童肿瘤的青春期前型良性畸胎瘤在成人中比在儿童中更常被检测到。在我们的系列研究中，成年良性睾丸畸胎瘤占所有纯畸胎瘤病例的21%。该领域的从业者必须意识到其在成年期也存在，以避免过度治疗，避免让患者接受不必要的化疗、腹膜后淋巴结清扫术（RLA）以及这些干预措施的潜在并发症。
