Çocukluk Çağı Testis Tümörlerinde İkincil Cerrahi

Abstract

Amaç: Testis tümörleri çocukluk çağı solid tümörlerin %1’ni oluşturmaktadır. Kliniğimizde testis tümörü tanısı ile tedavi edilmiş olan olguları geriye dönük değerlendirerek, ikincil cerrahi nedenlerini ve sonuçlarını literatür bilgisi ışığında tartışmayı amaçladık.Gereç ve Yöntemler: 2009-2013 yılları arasında testis tümör tanısı ile opere edilmiş olan olgular hastane kayıtlarından geriye dönük olarak değerlendirildi.Bulgular: İki ay-17 yaş arasındaki on yedi olgu testis tümörü tanısı ile kliniğimizde opere edildi. Sekiz olgu benign patolojiye sahipti; matür teratom (n=2), rest tümörü (n=1) , sertoliform adenom (n=1), keratinöz kist (n=1), basit mezotelyal kist (n=2), leydig hücreli tümör (n=1). Dokuz olgu malign patolojiye sahipti; paratestikuler rabdomyosarkom (n=1), yolk sac tümör (n=6), mikst germ hücreli tümör (n=2). Beş olguya testis koruyucu cerrahi, on iki hastaya yüksek orşiektomi uygulandı. Testis koruyucu cerrahi uygulanmış olan beş olguda komplikasyon gelişmedi. Başka merkezlerde skrotal girişim uygulanmış olan dört olguya hemiskrotektomi yapıldı. Hemiskrotektomi yapılan olgulardan birinde rezidü tümör saptandı. Retroperitoneal lenf nodu diseksiyonu yapılan üç olgudan birinin patolojisinde malignite saptandı.Sonuç: Testis tümörleri çocukluk yaş grubunda özellikle prepubertal dönemde nadir görülmekte ve genellikle benign karakterdedir. Cerrahi girişim her zaman inguinal kesi ile olmalı, testis koruyucu cerrahinin uygun görülmediği hastalara yüksek orşiektomi uygulanmalıdır. Germ hücreli tümörlerde sebat eden retroperitoneal hastalık varlığında lenf nodu diseksiyonu gerekliliği yönünden olgular değerlendirilmelidir.

Keywords

• Çocuk, Testis tümörleri

Redo Surgery in Childhood Testicular Tumors

Abstract

Objective: Testicular tumors make up 1% of childhood solid tumors. We retrospectively evaluated the patients who had been treated at our clinic with a diagnosis of testicular tumors and aimed to discuss the causes for redo surgery in the light of the literature.Material and Methods: We retrospectively analyzed patients who had been operated with the diagnosis of testicular tumors between 2009 and 2013 from the hospital records.Results: Seventeen patients with an age range from 2 months to 17 years were operated in our clinic with a diagnosis of testicular tumor. Eight patients had a benign pathologic results consisting of mature teratoma (n=2), rest tumor (n=1), sertoliform adenoma (n=1), keratinous cyst (n=1), simple mesothelial cyst (n=2), and Leydig cell tumor (n=1). Nine patients had a malign result consisting of paratesticular rhabdomyosarcoma (n=1), yolk sac tumor (n=6), and mixed germ cell tumor (n=2). Testis-sparing surgery was performed in five cases while high orchiectomy was performed in twelve cases. No complication was seen in the five patients who underwent a testis-sparing surgery. Hemiscrotectomy was performed in four patients who had undergone scrotal orchiectomy at other medical centers previously. Malignant residual tumor was found in a patient who underwent hemiscrotectomy. Malignancy was detected in one of three patients who underwent retroperitoneal lymphadenectomy. conclusion: Testicular cancers are seen rarely in childhood and especially in the prepubertal period and are usually benign. Surgery should always be with inguinal incision, and high orchiectomy should be administered in patients not appropriate for testis-sparing surgery. Retroperitoneal lymph node dissection (Redo surgery) can be required for the recurrence or residual retroperitoneal disease in the treatment of germ cell tumors

Keywords

• Child, Testicular neoplasms

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