Karmazyn B, et al. - A comparative scrutiny was carried out of the malignancy risk of primary testicular tumors in children in the prepubertal period (5–12 years) compared with younger (0–4 years) and pubertal (13–18 years) children. Data did not unveil any malignant testicular tumors in children aged 5 to 12 years with no risk factors prior to pubertal surge. Researchers recommended the use of a more conservative therapy in this study cohort.

Methods

• Between 2002-2016 candidates aged <18 years with surgery for primary testicular tumor were analyzed.
• Exclusion criteria comprised of subjects with testicular tumor risk.
• Experts appraised the ultrasound studies for contralateral testis volume, tumor morphology, and tumor maximal diameter, for 3 age groups: 0-4, 5-12, and 13-18 years.
• They adopted Freeman-Halton extension of the Fisher exact probability test for categorical outcomes and one-way ANOVA for continuous outcomes.

Results

• This study included 52 subjects (mean age 11.0 years, range 6 days to 18 years).
• A notable variation was determined in the malignant tumor prevalence (p < 0.01) among age groups (Fig.): 0-4 (72.7%, 8/11), 5-12 (0%, 0/16), and 13-18 years (44.0%, 11/25).
• Epidermoid cyst (31.3%, 5/16) and tumor mimics (37.5%, 6/16) were found to be the most common tumor types in 5-12 years.
• No marked difference was revealed in the prevalence of cystic tumors in 5-12 year olds compared with other age groups.
• As per the outcomes, contralateral testicular volume >4 mL (pubertal surge) varied notably (p < 0.01) among groups: 0-4 years (0/11), 5-12 years (3/16), and 13-18 years (19/20).
• The mean tumor maximal diameter (29.8±4.4 mm) was illustrated to be considerably larger in children aged 13-18 years (p < 0.01) than in children 5-12 years (9.3±5.5 mm).
• Furthermore, all malignant tumors presented with contralateral testicular volume >4 mL.