Kanematsu Akihiro, Yamamoto Shingo
Department of Urology Hyogo College of Medicine Hyogo Japan.
IJU Case Rep. 2021 Jun 9;4(5):289-292. doi: 10.1002/iju5.12328. eCollection 2021 Sep.
A standard protocol for testis-sparing surgery for pediatric benign testicular tumors has not been established to date.
We treated 7 teratomas in 6 patients aged 12 years of younger. For 2 noncystic lesions, the spermatic cord was exposed via the transinguinal approach and clamped until the establishment of an intraoperative pathological diagnosis. The other 5 tumors in 4 infant patients were all preoperatively diagnosed with cystic teratoma, and we essentially exposed the testis directly via the scrotal approach and enucleated the tumor without clamping the cord. In every case, adequate amount of normal testicular tissue was preserved, without any local recurrence with 3-year minimum follow-up.
An unclamped enucleation of testicular tumor via the transscrotal approach, which is contraindicated in most testicular tumors, can be a treatment choice exclusively for preoperatively diagnosed mature cystic teratoma in infants.
迄今为止,尚未建立小儿良性睾丸肿瘤保留睾丸手术的标准方案。
我们治疗了6例12岁及以下患者的7例畸胎瘤。对于2例非囊性病变,经腹股沟入路暴露精索并夹闭,直至术中病理诊断明确。4例婴儿患者的另外5个肿瘤术前均诊断为囊性畸胎瘤,我们基本上经阴囊入路直接暴露睾丸,摘除肿瘤而不夹闭精索。每例均保留了足够量的正常睾丸组织,至少随访3年无局部复发。
经阴囊入路不夹闭精索摘除睾丸肿瘤,这在大多数睾丸肿瘤中是禁忌的,但对于术前诊断为婴儿成熟囊性畸胎瘤的情况可以作为一种治疗选择。