Elsevier

Urology

Volume 117, July 2018, Pages 142-144
Urology

Pediatric Case Reports
Testicular Yolk Sac Tumor and Mature Teratoma: Synchronous Bilateral Occurrence in an Infant

https://doi.org/10.1016/j.urology.2018.03.025Get rights and content

Yolk sac tumor (YST) is a rare malignancy typically occurring in children. However, bilateral testicular YSTs are a quite rare situation, which can occur metachronously or synchronously with same histologic type, as well as different histology. We present a case of synchronous YST of the left testis and mature teratoma of the right in a 7-month-old infant treated with testis-sparing surgery at right testis and high radical orchiectomy at left. By follow-up of 28th month, no atrophy, or residual tumor in right testis and no recurrence or evidence of disease in left scrotum was found.

Section snippets

Case Presentation

A 7-month-old infant was referred to our hospital with a 1 month history of nontender, left testicular mass. Physical examination demonstrated a normal boy appearance without evidence of hydrocele or hernia. His testes were descended bilaterally. A small firm mass was palpable within the left testis and the right testis was palpably normal. Scrotal ultrasound revealed a homogeneous hypoechoic solid mass with rich blood supply in the middle-lower pole of the left testis, measuring 16 mm

Comment

Testicular YST usually presents as an asymptomatic testicular enlargement and has occurred in children under 2 years of age, characterizing by hypervascular solid mass in ultrasonography and elevation of serum AFP level.2, 3, 7, 8 In our case, the patient had an AFP of 243 ng/ml. Admittedly, the AFP may be physiologically elevated in infants; however, children aged younger than 1 year with elevated AFP >100 ng/ml should be presumed to have a yolk sac tumor.2

Cases of bilateral testicular YSTs

Conclusion

Benign lesions represent the majority of testicular masses in prepubescent children, with most that are malignant being YST. Synchronous YST and mature teratoma of the testes in children are exceedingly rare. The treatment of patients with bilateral testicular YSTs should be based upon the clinical stage, patient age, and the histopathologic type of the tumors, and refer to the standard management of the unilateral testicular YST. The reliability of both ultrasound and intraoperative frozen

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