[Primary testicular tumors in childhood. Observations in 21 cases and a discussion of the necessity of metastasis prevention].

A retrospective analysis of 21 primary testicular tumors in childhood is presented. Histologic review revealed 4 differentiated teratomas, 14 yolk sac tumors, 1 rhabdomyosarcoma of testicular envelopes and 1 paratesticular sarcoma. One tumor could not be classified. Two patients with yolk sac tumor and the patient with the paratesticular sarcoma died. In 4 of the 14 patients with yolk sac tumor iliac and/or paraaortic lymphnodes were removed 8-15 days after hemicastration but no tumor cells were found. Of 3 children with yolk sac tumor who developed metastases, one had had prophylactic resection and another one prophylactic irradiation of the draining lymphnodes. 8 patients with yolk sac tumor received prophylactic chemotherapy, and none developed metastases. For patients with yolk sac tumor prophylactic chemotherapy is indicated, particularly if more than 2 months have elapsed between the first detection of a testicular mass and operation. In prepubertal boys with testicular teratoma no prophylactic therapy to prevent dissemination is necessary. Patients with yolk sac tumor have an age distribution comparable to that of patients with an embryonal tumor.