What are testicular tumors?
Testicular tumors are growths on the testicle. They usually occur in the first 2 years of life or during young adulthood after boys enter puberty. The tumors in children that occur during the first 2 years of life are generally different than the ones that occur after the onset of puberty.
Before age 2 most testicular tumors are benign and do not spread throughout the body. However, they still require an operation. Some testicular tumors that occur in young children can be malignant, and these can spread throughout the body to the lungs, liver, lymph nodes, brain or spinal cord. After onset of puberty most of the testicular tumors are malignant.
The cause of testicular cancer is unknown, but most of them originate in the cells that are involved in making sperm in the testicles (the germ cells). Boys with undescended testicles have an increased risk of developing testicular tumors.
What are the symptoms of a testicular tumor?
A painless lump in the testicle is the most common symptom of a testicular tumor. Other symptoms may include a feeling of heaviness in the scrotum, a dull ache in the groin and pain or discomfort in the testicle or scrotum.
How is a testicular tumor diagnosed?
Often there will be swelling, hardness, abnormal shape or symmetry as compared to the other side. Occasionally these findings are recognized after an injury because attention is placed on the testicles. The best way to identify a mass is from regular self exams especially if your child was born with an undescended testicle. Your child should do regular, monthly self exams of both testicles to evaluate for a mass beginning at puberty until approximately age 50, at which point the risk decreases significantly. Sometimes testicular cancer is recognized when a young child begins to go through puberty before the generally expected time.
Diagnosis needs to be made quickly. Do not wait to see if the mass will go away. Have your doctor examine the mass. Your doctor will order an ultrasound to better identify the mass. If there is a high level of concern the doctor will then likely order a CT scan of the abdomen and pelvis and some lab work.
How is a testicular tumor treated?
Treatment for a testicular tumor begins with removal of the testicle (orchiectomy) through an incision in the groin. Sometimes, depending on the characteristics of the tumor on ultrasound just the tumor can be removed (partial orchiectomy) and the remaining portion of the testicle without the tumor can be spared. Depending on the type of type of tumor follow-up treatment may include surveillance, chemotherapy, or radiation. If further treatment is needed your child will also see a pediatric oncologist.
What happens after treatment of a testicular tumor?
If the tumor was a cancer your child still will usually have a good prognosis. Your child’s prognosis will depend on the extent of the disease at the time of diagnosis. It is very important that if a mass is noted that you seek medical advice promptly as lower stages of cancer are much easier to cure. Some children will be able to maintain their fertility with a single testicle even after chemotherapy and radiation. Continual follow up is very important to monitor for effects of the chemotherapy, radiation therapy and to evaluate for possible secondary tumors that can develop after treatment with chemotherapy or radiation.