Xia Qiongzhang, Kuang Tongshuai, Lin Xiaokun, Zhang Hua
Department of Pediatric Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Wenzhou Key Laboratory of Children Genitourinary Diseases, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Front Pediatr. 2023 May 17;11:1142157. doi: 10.3389/fped.2023.1142157. eCollection 2023.
Testicular tumors in the intra-abdominal undescended testis are rare in children, and their management remains challenging. The aim was to present a case report and review of the literature about diagnosis and treatment of testicular tumors arising from undescended intra-abdominal testis in children.
In this study, we retrospectively analyzed the clinical records of a 1-year-old male patient admitted to pediatric surgery in March 2022 with a testicular tumor originating in the intra-abdominal undescended testis. Furthermore, medical literature published in English during the last three decades was systematically searched through the databases of Medline, PubMed, and Google Scholar.
The patient underwent laparoscopic orchiopexy and tumor excision. The operation was uneventful, and the patient recovered well without complications. An 8-month follow-up showed no recurrence of the teratoma after postoperative pathology. The literature search resulted in the retrieval of 16 non-duplicate articles, and 16 patients were included in this review. The cases included six cases of left cryptorchidism and 10 cases of right cryptorchidism, with an average age of 15.3 months. The largest transverse diameter of the tumors ranged from 1.8 to 12.5 cm, with an average tumor length of 6.7 cm. All patients underwent surgical treatment, including three cases of laparoscopic orchiectomy, a sole case of a conversion of inguinal incision to laparotomy and orchiectomy, and 12 cases of laparotomy and orchiectomy. Postoperative pathology revealed 12 cases of mature teratoma, two cases of immature teratoma, one case of yolk sac tumor, and a single case of embryonic carcinoma combined with yolk sac tumor. 11 patients were followed up, and one of them recurred.
Abdominal ultrasound (US) or abdominal computer tomography (CT) should be performed in cases of undescended testis suspected to have testicular tumors on clinical findings. The most common type of intra-abdominal testicular tumor is mature teratomas. Early diagnosis and prompt surgical intervention resulted in an excellent outcome.
儿童腹腔内隐睾的睾丸肿瘤罕见,其治疗仍具有挑战性。本文旨在报告1例儿童腹腔内隐睾来源的睾丸肿瘤的诊治情况,并对相关文献进行综述。
本研究回顾性分析了1例2022年3月因腹腔内隐睾来源的睾丸肿瘤入住小儿外科的1岁男性患者的临床资料。此外,通过Medline、PubMed和谷歌学术数据库系统检索了过去三十年发表的英文医学文献。
患者接受了腹腔镜睾丸固定术和肿瘤切除术。手术顺利,患者恢复良好,无并发症。术后8个月随访显示,术后病理检查畸胎瘤无复发。文献检索共获得16篇非重复文章,本综述纳入16例患者。其中左侧隐睾6例,右侧隐睾10例,平均年龄15.3个月。肿瘤最大横径为1.8~12.5 cm,平均肿瘤长度为6.7 cm。所有患者均接受了手术治疗,包括3例腹腔镜睾丸切除术、1例腹股沟切口转为剖腹手术并睾丸切除术,以及12例剖腹手术并睾丸切除术。术后病理显示成熟畸胎瘤12例,未成熟畸胎瘤2例,卵黄囊瘤1例,胚胎癌合并卵黄囊瘤1例。11例患者接受了随访,其中1例复发。
对于临床怀疑有睾丸肿瘤的隐睾患者,应进行腹部超声(US)或腹部计算机断层扫描(CT)检查。腹腔内睾丸肿瘤最常见的类型是成熟畸胎瘤。早期诊断和及时的手术干预可取得良好的治疗效果。