Testicular tumors in children are rare. If it’s found early, treatment is often successful. If it’s found after it has spread, it’s harder to treat. As with men, this cancer often begins as a painless lump. The most common type in boys are yolk sac tumors and teratomas. The cancer cell-types found are:
- Yolk Sac Tumors. When these tumors grow in adults, they are more unsafe.
- Teratomas. These germ cells grow in hard to predict ways and do not respond to chemotherapy. They can be treated with surgery.
- Gonadal Stromal Tumors. These are more likely to spread and require a chest x-ray if found.
- Gonadoblastoma and Dysgerminoma are rare. They happen in children with testicles that did not grow normally before birth.
- Gonadoblastomas are benign. They can become cancer in 50% of cases.
The most common treatments for children are:
- Inguinal Exploration. For this surgery, a cut on the skin crease just above the pubic bone is made and the testicle is guided out of the scrotum. The surgeon then looks at the gland to decide next steps. This is recommended for any child with a testicular tumor. It is most often an outpatient service.
- Testis Sparing Surgery (TSS). This is an choice when the surgeon thinks the tumor is benign. A surgeon decides on TSS based on how the tumor looks and on normal tumor markers. In this case, just the tumor tissue is removed. It is sent for tests (biopsy) by a pathologist.
- Total Orchiectomy. Surgery to remove the testis is needed if biopsy results show cancer. Also, it is done with high tumor markers, a large tumor, and if a tumor is found after puberty.
- Further treatment is offered if the cancer is more aggressive. These options include the RLND, radiation, or chemotherapy.
After treatment, children are checked for at least two years to make sure all is well. Physical exams, tumor marker tests and chest x-rays are common follow-up tests. Most often boys do not look different if a testicle is removed. The scrotum is not cut and the other testicle keeps growing. If a boy does not like the result, a prosthesis is an option. This is most often done after puberty.
Most boys who’ve been treated for testicular cancer will be healthy, and can have children when they grow up.