Testicular germ cell tumors make up 0.5% of pediatric malignancies, and 14% of adolescent malignancies.
Young boys have primarily pure teratoma and pure yolk sac histologies; however, adolescent histology is mostly mixed nonseminomatous germ cell tumor.
Surgical excision of the primary tumor is the crux of treatment. Chemotherapy, retroperitoneal lymph node dissection, and targeted treatment of distant metastases make even widely disseminated disease treatable. Since the discovery of platinum-based chemotherapy, testicular germ cell tumors are a highly curable disease. However, adolescents remain the group with the highest mortality.
Focus has expanded beyond survival to emphasize quality of life issues when optimizing treatment algorithms.
Urol Oncol. 2015 Jul 14. pii: S1078-1439(15)00296-3. doi: 10.1016/j.urolonc.2015.06.008. [Epub ahead of print]
Grantham EC1, Caldwell BT1, Cost NG2.
1 Division of Pediatric Urology, Children׳s Hospital Colorado and University of Colorado Denver, Aurora, CO.
2 Division of Pediatric Urology, Children׳s Hospital Colorado and University of Colorado Denver, Aurora, CO.