Perspectives in Pediatric Pathology,Chapter 25. Testicular and Paratesticular Tumors in the Pediatric Age Group

Testicular tumors in the prepubertal age are relatively rare, representing only 9.4% of the total testicular and paratesticular specimens from a 20-year review performed at a large pediatric hospital [1]. They account for 1% to 2% of all solid tumors in the pediatric age group, with an annual incidence between 0.5/100000 and 2/100000 boys according to Coppes et al [2] and data from the Prepubertal Testicular Tumor Registry [3]. Similar to other neoplasms afflicting children, a bimodal age distribution is observed. The first peak is between birth and 3 years of age, and a second one occurs at the onset of puberty, extending to the fourth decade. Reports on their frequency vary because some investigators include the adolescent period, while others do not [4]. The vast majority of testicular tumors are germ cell neoplasms, accounting for 95% across all ages [5]. In children, germ cell tumors also predominate, representing 71% of all testicular neoplasms. These include yolk sac tumors (49%), teratomas (13%), seminomas and mixed germ cell tumors (9%), and sex-cord stromal tumors (29%). Malignant potential is significantly lower (less than 70%) in the pediatric age group compared to adults (90%) [6]. According to Pohl et al, 74% of prepubertal testicular tumors are benign [7].