Ünal BIÇAKÇI, Dilek DEMİREL, Sertaç HANCIOĞLU, Ender ARITÜRK, Ferit BERNAY

Çocukluk Çağı Testis Tümörleri

AmaçTestis tümörleri çocukluk çağında nadir görülmektedir. Bu çalışmada kliniğimizde testis tümörü nedeni ile ameliyat edilen olguların değerlendirilmesi amaçlandı.Hastalar ve yöntem2006- 2016 tarihleri arasında testiste kitle nedeniyle ameliyat edilen 20 hasta yaş, başvuru bulguları, taraf, metastaz varlığı, uygulanan cerrahi, histopatolojik değerlendirme sonuçları, ameliyat öncesi AFP ve βHCG düzeyleri açısından geriye dönük olarak incelendi. BulgularYaşları 0,4- 17,5 yıl arasında (ortalama 8,8 yıl) olan 20 hasta çalışmaya alındı. Tamamı ağrısız skrotal şişlikle başvurdu. Ameliyat öncesi 9 (% 45) hastanın (5 teratom ve 4 endodermal sinüs tümörü) AFP ve 4 (% 20) hastanın (3 teratom ve 1 endodermal sinüs tümörü) βHCG değeri yüksekti. Hastaların 5’inde tanı esnasında metastaz vardı (2 akciğer ve 3 retroperitoneal lenf nodu). Hastaların 8’ine (% 40) frozen biyopsi sonrası orşiektomi, 9’una (% 45) orşiektomi, 1’ine (% 5) frozen biyopsi sonrası testis koruyucu cerrahi, neoplastik infiltrasyon olan 2 (% 10) hastaya ise doku tanısı için sadece testis biyopsisi uygulandı. Histopatolojik incelemede 13 (% 65) hastada germ hücreli tümör bulundu. Bunlar; 4 (% 20) endodermal sinüs tümörü, 5 (% 25) mikst germ hücreli tümör, 3 (% 15) teratom, 1 (% 5) seminom)’du. 4 (% 20) hastada neoplastik infiltrasyon, 2 (% 10) hastada paratestiküler rabdomyosarkom, 1 (% 5) hastada ise malign mezenkimal tümör görüldü. Hastaların 15’i (% 75) kemoterapi, 2’si (% 10,5) radyoterapi aldı. Hastalardan 5’inde (% 25) metastaz görüldü. Takiplerinde neoplastik infiltrasyonu olan 2 (% 10,5) hasta exitus oldu. Sonuç Çocukluk çağı testis malignitelerinde uygun hastalarda testis koruyucu cerrahi denenmelidir. Frozen biyopsi cerrahi yöntemin belirlenmesinde yardımcıdır.

Anahtar Kelimeler:

Çocukluk çağı testis tümörleri, frozen biyopsi, testis koruyucu cerrahi

Childhood Testicular Tumors

ObjectiveTesticular tumors are rare in childhood In this study, it was aimed evaluate our patients with testicular tumor.Patients and methodsTwenty patients had been evaluated between 2006- 2016 in terms of age, presenting symptoms, side, presence of metastasis, surgical intervention, histopathological evaluation results, preoperative AFP and βhcg levels. ResultsTwenty patients were between 0.4 and 17.5 years old (median 8.8 years). Preoperative AFP values were high in 9 (45%) patients (5 teratom and 4 endodermal sinus tumor) and βHCG values were high in 4 (20%) patients (3 teratom and 1 endodermal sinus tumor). At diagnosis, 5 patients had metastasis ( 2 luns and 3 retroperitoneal lymh nodes). 8 (40%) patients underwent orchiectomy after frozen biopsy, 9 (45%) patients underwent orchiectomy, 1 (5%) patient underwent testis sparing surgery after frozen biopsy. Histopathological examination revealed that there was germ cell tumor in 13 (65%) patients including endodermal sinus tumor in 5 (25%) patients, mixed germ cell tumor in 4 (20%) patients, teratoma in 3 (15%) patients, seminoma in 1 patient), neoplastic infiltration in 4 (20%) patients, paratesticular rhabdomyosarcoma in 2 (10%) patients and malign mesenchymal tumor in 1 (5%) patient. 14 (70%) patients received chemotherapy and 2 (10.5%) patients received radiotherapy. Metastases developed in 3 (15.7%) of the patients. Two (10.5%) patients with neoplastic infiltration were exitus. Conclusion In childhood testicular malignancies, testis sparing surgery should be tried in appropriate patients. Frozen biopsy is helpful in determining surgical method.

Keywords:

Childhood testicular tumors, frozen biopsy,

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