Treatment of Testicular Yolk Sac Carcinoma in the Young Child

Publisher Website
Google Scholar
Abstract
The majority of testicular tumors in children will be of germ cell origin; the predominant pathologic type is the yolk sac carcinoma. Initial treatment of radical orchiectomy is not in question. Because of its presumed less virulent character, especially in children < 2 yr old, confusion remains as to adjunctive treatment for yolk sac carcinoma. Retrospectively, 21 children with testis tumors encountered within the last 10 yr were studied. Of these cases, 12 were classified pathologically as yolk sac carcinoma. All children were < 3 yr old; 10 of 12 were < 2 yr old. Of the 12 cases, 4 had positive lymph node dissections; 3 of these 4 children were < 2 yr old. Although chemotherapy is so effective its toxicity cannot be minimized. Therefore, adjunctive chemotherapy should be reserved for those patients who have lymphatic spread. Young children with yolk sac tumors are not immune to metastatic disease and should be treated with an extended unilateral lymphadenectomy for staging and appropriate treatment regimens.