Testicular Tumors In Children: A Single Institution Experience
1
performed preoperatively and the histology showed a juvenile renal cell carcinoma. All cases subsequently underwent LRN. Four trocars were used in each case and the tumours were placed in a bag before to be extracted without morcellation through a low suprapubic incision. RESULTS All tumours as well as lymph node samples were removed completely by laparoscopy without rupture. No conversion to laparotomy was necessary and there were neither intraoperative bleeding nor complications. The mean operative time was 90 min. In postoperative, one child presented an intestinal perforation and was suture clousure by laparoscopy; the discharge was at 10 days, and the others were discharged after two or three days. In all cases, the resection was microscopically complete. None of these patients presented evidence of recurrences, port-site implantation and short-term complications. The histology was 4 unilateral WT, 1 clear cell sarcoma and 1 juvenile renal cell carcinoma with t(X;17). CONCLUSIONS LRN for renal cancer in children is feasible and safe after preoperative chemotherapy, with the same oncological strategies than open surgery. A long follow-up and more cases are necessary to evaluate and compare the results of laparoscopic approach with the open procedures. # S15-4 (O) TESTICULAR TUMORS IN CHILDREN: A SINGLE INSTITUTION EXPERIENCE Luis VILLEGAS, Michael LEONARD, Claudio DE CARLI and Luis GUERRA Children’s Hospital of Eastern Ontario, Division of Paediatric Urology, Ottawa, CANADA PURPOSE Testicular tumors account for 1-2% of all paediatric solid tumors. We describe a single center experience in the diagnosis and surgical treatment of testicular tumors in a paediatric population. MATERIAL AND METHODS Research Ethics Board approved retrospective chart review of testicular tumors treated at our institution from 1990-2008. RESULTS Twenty-six patients with 27 tumors, 15 prepubertal and 12 post-pubertal. Median age 7.4 years (Quartiles 1st: 0.7; 3rd: 15.4). Median follow up 36 months (Quartiles 1st: 14.1; 3rd: 80.7). Painless testicular mass in 52%(14/27). Alpha- fetoprotein(AFP) was high in 80%(8/10) and 12% (2/17) of malignant and benign tumors respectively. Human Chorionic Gonadotropin(HCG) was high in 20%(2/10) of the malignant tumors, and both patients were post-pubertal. Benign and malignant tumors were 63%(17/27) and 37%(10/27) respectively. Benign lesions were present in 73%(11/15) of prepubertal and 50%(6/12) of post-pubertal. AFP was normal in 82%(9/11) of benign and high in 100%(4/4) of malignant prepubertal patients (p¼0.011). Pathology: 82%(22/27) germ cell tumors, 15%(4/27) gonadal stromal and 3%(1/27) cystic dysplasia. Radical and partial orchiectomy was performed in 89%(24/27) and 11%(3/27) respectively. Stage I was found in 88.9%(24/27) and II, III and IV in 3.7 %(1/27) each. There was no death during the follow up. CONCLUSIONS Benign testicular tumors were more frequent in our series. As most prepubertal tumors were benign (73%) and AFP was high in all prepubertal malignant tumors, partial orchiectomy in patients younger than 12 years with a normal AFP could be considered. HGC had no value on assessment of tumors in prepubertal age. # S15-5 (DP) TRANSITIONAL CELL CARCINOMA OF THE BLADDER IN CHILDREN AND ADOLESCENTS: 5-CASE SERIES Javier LERENA 1 , Lucas KRAUEL 1 , Santiago VALLASCIANI 2 , Luis GARCIA-APARCIO 1 , Noelia PEREZ 3 , Freud CACERES 1 and Joan RODO 1 1 Hospital Sant Joan de De´u, Universitat de Barcelona, Urology Unit, PediatricSurgery, Barcelona, SPAIN, 2 Ospedale Pediatrico Bambino Gesu`, Andrological and Gynaecological Surgery Unit. Nephro-Urologic Department, Roma, ITALY, 3 Hospital Sant Joan de De´u, Universitat de Barcelona, Pathology Department, Barcelona, SPAIN PURPOSE Lower urinary tract tumours are very rare in paediatric age. Among them, transitional cell carcinoma of the bladder (TCCB) is even less frequent in the first two decades of life and exceptional under 10 years of age. The present series aims to expand the reported cases in literature. MATERIAL AND METHODS Between 1984 and 2006, four patients (4 male, 1 female) were treated in our Center. Their ages were 6, 9, 13, 14 and 17 years old. Clinical presentation was macroscopic hematuria in 4 and pielonefritis in one. Physical examination, laboratory analysis, ultrasound and cistoscopy were performed in all patients before surgical treatment. Follow up was ensured by clinical and ultrasound assessment. RESULTS Physical examination and laboratory analysis did not revealed any significant result. By the other hand, ultrasound showed exophytical intravesical lesions. ESPU Programme 2009 S89
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Transcript of Testicular Tumors In Children: A Single Institution Experience
ESPU Programme 2009 S89
performed preoperatively and the histologyshowed a juvenile renal cell carcinoma. Allcases subsequently underwent LRN. Fourtrocars were used in each case and thetumours were placed in a bag before to beextracted without morcellation througha low suprapubic incision.
RESULTS
All tumours as well as lymph node sampleswere removed completely by laparoscopywithout rupture. No conversion to
laparotomy was necessary and there wereneither intraoperative bleeding norcomplications. The mean operative time was90 min. In postoperative, one childpresented an intestinal perforation and wassuture clousure by laparoscopy; thedischarge was at 10 days, and the otherswere discharged after two or three days. Inall cases, the resection was microscopicallycomplete. None of these patients presentedevidence of recurrences, port-siteimplantation and short-term complications.The histology was 4 unilateral WT, 1 clear
cell sarcoma and 1 juvenile renal cellcarcinoma with t(X;17).
CONCLUSIONS
LRN for renal cancer in children is feasibleand safe after preoperative chemotherapy,with the same oncological strategies thanopen surgery. A long follow-up and morecases are necessary to evaluate andcompare the results of laparoscopicapproach with the open procedures.
# S15-4 (O)
TESTICULAR TUMORS IN CHILDREN: A SINGLE INSTITUTION EXPERIENCE
Luis VILLEGAS, Michael LEONARD, Claudio DE CARLI and Luis GUERRAChildren’s Hospital of Eastern Ontario, Division of Paediatric Urology, Ottawa, CANADA
PURPOSE
Testicular tumors account for 1-2% of allpaediatric solid tumors. We describe a singlecenter experience in the diagnosis andsurgical treatment of testicular tumors ina paediatric population.
MATERIAL AND METHODS
Research Ethics Board approvedretrospective chart review of testiculartumors treated at our institution from1990-2008.
RESULTS
Twenty-six patients with 27 tumors, 15prepubertal and 12 post-pubertal. Median
age 7.4 years (Quartiles 1st: 0.7; 3rd:15.4). Median follow up 36 months(Quartiles 1st: 14.1; 3rd: 80.7). Painlesstesticular mass in 52%(14/27). Alpha-fetoprotein(AFP) was high in 80%(8/10) and12% (2/17) of malignant and benign tumorsrespectively. Human ChorionicGonadotropin(HCG) was high in 20%(2/10)of the malignant tumors, and both patientswere post-pubertal. Benign and malignanttumors were 63%(17/27) and 37%(10/27)respectively. Benign lesions were present in73%(11/15) of prepubertal and 50%(6/12) ofpost-pubertal. AFP was normal in 82%(9/11)of benign and high in 100%(4/4) ofmalignant prepubertal patients (p¼0.011).Pathology: 82%(22/27) germ cell tumors,15%(4/27) gonadal stromal and 3%(1/27)cystic dysplasia. Radical and partialorchiectomy was performed in 89%(24/27)
and 11%(3/27) respectively. Stage I wasfound in 88.9%(24/27) and II, III and IV in3.7 %(1/27) each. There was no deathduring the follow up.
CONCLUSIONS
Benign testicular tumors were morefrequent in our series. As most prepubertaltumors were benign (73%) and AFP was highin all prepubertal malignant tumors, partialorchiectomy in patients younger than 12years with a normal AFP could beconsidered. HGC had no value on assessmentof tumors in prepubertal age.
# S15-5 (DP)
TRANSITIONAL CELL CARCINOMA OF THE BLADDER IN CHILDREN AND ADOLESCENTS: 5-CASE SERIES
Javier LERENA1, Lucas KRAUEL1, Santiago VALLASCIANI2, Luis GARCIA-APARCIO1, Noelia PEREZ3, Freud CACERES1
and Joan RODO1
1Hospital Sant Joan de Deu, Universitat de Barcelona, Urology Unit, Pediatric Surgery, Barcelona, SPAIN, 2Ospedale Pediatrico BambinoGesu, Andrological and Gynaecological Surgery Unit. Nephro-Urologic Department, Roma, ITALY, 3Hospital Sant Joan de Deu,Universitat de Barcelona, Pathology Department, Barcelona, SPAIN
PURPOSE
Lower urinary tract tumours are veryrare in paediatric age. Among them,transitional cell carcinoma of thebladder (TCCB) is even less frequent inthe first two decades of life andexceptional under 10 years of age. Thepresent series aims to expand thereported cases in literature.
MATERIAL AND METHODS
Between 1984 and 2006, four patients (4male, 1 female) were treated in ourCenter. Their ages were 6, 9, 13, 14 and17 years old. Clinical presentation wasmacroscopic hematuria in 4 andpielonefritis in one. Physical examination,laboratory analysis, ultrasound andcistoscopy were performed in all patients
before surgical treatment. Follow up wasensured by clinical and ultrasoundassessment.
RESULTS
Physical examination and laboratoryanalysis did not revealed any significantresult. By the other hand, ultrasoundshowed exophytical intravesical lesions.
