Conservative Management of Testicular Endodermal Sinus Tumor in Childhood

Publisher Website
Google Scholar
Abstract
Endodermal sinus tumor is the most common testicular neoplasm in childhood. The management of children with this neoplasm remains controversial. Children (5) with stage I endodermal sinus tumor were prospectively treated with limited surgery and no adjuvant therapy. The median patient age at diagnosis was 21 mo. (range 5-24 mo.). All children underwent an inguinal orchiectomy with high ligation of the spermatic cord. Retroperitoneal node dissection was not performed in any case, and no child received adjuvant chemotherapy or radiation therapy. All patients were well without evidence of recurrent disease at a median followup of 46 mo. (range 19-72 mo.). Because these tumors usually are localized at the time of diagnosis, rarely spread to the retroperitoneal nodes and have a biological marker in most cases, and because good salvage chemotherapy is available for patients with relapse, nonmetastatic testicular endodermal sinus tumors in children can be managed with radical orchiectomy alone. Retroperitoneal node dissection is not necessary, and adjuvant therapy is not indicated if markers return to normal. Further treatment should be reserved for the rare child with relapse.