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Treatment of Childhood Testicular Cancer
Source: Childhood Testicular Cancer Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: September 5, 2024 · Captured 2026-09-09.
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The European Cooperative Study Group for Pediatric Rare Tumors within the PARTNER project (Paediatric Rare Tumours Network - European Registry) has published comprehensive recommendations for the diagnosis and treatment of sex cord–stromal tumors in children and adolescents.[1]
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Treatment options for childhood testicular cancer (non–germ cell tumors) include the following:
Surgery.
There are conflicting data about malignant potential in older males. Most case reports suggest that in pediatric patients, these tumors can be treated with surgery alone.[2,3][Level of evidence C1]; [4][Level of evidence C2] It is prudent to check alpha-fetoprotein (AFP) levels before surgery. Elevated AFP levels usually indicate a malignant germ cell tumor. However, AFP levels and decay in levels are often difficult to interpret in infants younger than 1 year.[5]
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Evidence (surgery):
In a study of patients prospectively reported to the German Maligne Keimzelltumoren (MAKEI) registry, 42 patients with sex cord–stromal tumors were identified. All tumors were confined to the testes. Patients were treated with surgery alone, according to specific germ cell tumor guidelines.[6][Level of evidence C1]
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In a study of patients prospectively reported to the German Maligne Keimzelltumoren (MAKEI) registry, 42 patients with sex cord–stromal tumors were identified. All tumors were confined to the testes. Patients were treated with surgery alone, according to specific germ cell tumor guidelines.[6][Level of evidence C1]
There were no tumor recurrences.
A French registry identified 11 boys with localized sex cord–stromal testicular tumors. All 11 boys were treated with surgery alone.[7][Level of evidence C1]
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A French registry identified 11 boys with localized sex cord–stromal testicular tumors. All 11 boys were treated with surgery alone.[7][Level of evidence C1]
There were no tumor recurrences.
The benign behavior of pediatric non–germ cell testicular tumors has led to reports of testis-sparing surgery.[8-12] In one series of 12 patients with Leydig cell tumors (aged 4.2–14.7 years), 3 were treated with enucleation alone, and 9 were treated with orchiectomy.[13][Level of evidence C1]
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The benign behavior of pediatric non–germ cell testicular tumors has led to reports of testis-sparing surgery.[8-12] In one series of 12 patients with Leydig cell tumors (aged 4.2–14.7 years), 3 were treated with enucleation alone, and 9 were treated with orchiectomy.[13][Level of evidence C1]
All patients were alive at the last follow-up.
Given the rarity of this tumor, the best surgical approach in pediatrics has not yet been defined.
Publication references
Read the original reference and check its publication notices.
- PubMed 11696779 · Original source
- PubMed 16890643 · Original source
- PubMed 20850634 · Original source
- PubMed 23733594 · Original source
- PubMed 25053523 · Original source
- PubMed 26094168 · Original source
- PubMed 26206391 · Original source
- PubMed 29554024 · Original source
- PubMed 33760357 · Original source
- PubMed 9592840 · Original source
Preserved source evidence · Not medical advice