Torsion of an intra-abdominal teratoma of testis

Mature teratoma arising from an intraabdominal testis in a 2-month-old boy: case report and review of intraabdominal testicular tumors in children

Tumors arising in an undescended testis are rare in infants. We report a mature teratoma in an intraabdominal testis of a 2-month-old boy. He presented with a large left-sided abdominal mass and nonpalpable left testis. Abdominal ultrasound and computed tomography showed a well-defined, sizable cystic tumor with focal calcification in the lower abdomen. Tumor markers were all within normal limits. Surgical resection revealed a large tumor arising from an intraabdominal left testis, and histologic analysis identified a mature teratoma. The tumor was completely removed, and there was no recurrence at follow-up 3 years later. The histologic condition of prepubertal intraabdominal testicular (IAT) tumors is quite different from that of testicular tumors in childhood descended testes and postpubertal IAT tumors. A total of 30 cases of IAT tumors in children, including our case, were reviewed to elucidate this issue.

Mature teratoma arising in intraabdominal undescended testis in an infant with previous inguinal exploration: case report and review of intraabdominal testicular tumors in children

The authors report the youngest case of postoperative intraabdominal mature testicular teratoma in a 5-year-old boy after previous exploration for impalpable testis. A total of 26 cases of intraabdominal testicular tumor in children including our case were reviewed and discussed from both the English- and the Japanese-language literature. The average age was 2.5 years, and, in the 13 children younger than 1 year there were no malignant teratomas, although there was one immature teratoma. Four of these had undergone previous inguinal exploration in which 3 patients except our patient were more than 10 years old. This case report confirms the importance of finding an intraabdominal testis at operation for impalpable testis. Early detection of the testicular location near the internal inguinal ring in these patients supports the hypothesis that the intraabdominal testicular teratoma itself may have been the primary cause of the undescended testis. Furthermore, it is suspected that many of the intraabdominal testicular malignant teratomas in adults may have arisen from these mature testicular teratomas in infants.

Torsion of intraabdominal testicular tumors. A case report

BACKGROUND

Torsion of an intraabdominal testicular tumor is a rare event. We report a new case and review the literature.

METHODS

A review of the literature was carried out in order to identify reported cases of an intraabdominal testicular tumor undergoing torsion of its vascular pedicle. Data on histologic type, common presenting signs and symptoms, radiographic studies, and adjuvant therapy were tabulated.

RESULTS

There are 36 reports of an intraabdominal testicular tumor presenting with torsion. The most common histologic types, in descending order, were seminoma, sarcoma, teratoma, embryonal carcinoma, and choriocarcinoma. Common presenting signs and symptoms included pain and/or tenderness, fever, nausea and/or vomiting, and a palpable mass. Most seminoma patients received adjuvant radiation therapy whereas one patient with choriocarcinoma received adjuvant chemotherapy.

CONCLUSIONS

Although a rare event, the diagnosis of torsion of an intraabdominal testicular tumor should be considered in any patient presenting with an acute abdomen and a history of cryptorchidism. The presence of a mass may raise the index of suspicion. Preoperative investigation with computed tomography scanning may aid surgical planning.

A child with an intra-abdominal testicular teratoma: a case report and review of prepubertal cryptorchid germ cell tumors

OBJECTIVES

We report the case of a tumor in an intra-abdominal cryptorchid testis of a 7-month-old male infant. Torsion of a testicular teratoma was confirmed by pathologic examination. A review was undertaken to identify and characterize other reports of prepubertal cryptorchid germ cell neoplasms.

METHODS

Cases of testicular germ cell neoplasms in association with cryptorchidism in phenotypically normal males were identified through a MEDLINE search of the English literature and review of published bibliographies.

RESULTS

A total of 14 cases were identified with testis location provided in 12 patients. Half of the neoplasms were located in abdominal testis, and all of these were associated with torsion, although 2 of 6 patients were asymptomatic. Two patients had tumors in the contralateral normally descended testis. Teratoma was the most frequently encountered tumor type.

CONCLUSIONS

Characteristics of prepubertal cryptorchid testicular germ cell tumors reflect those seen in post-pubertal cryptorchid tumors in location but differ in histologic type. Possible pathogenesis is discussed. Follow-up was not provided in all cases although outcome appears to be good. We believe that these lesions are likely underreported.