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Medical news
of the North Caucasus
Scientific journal
Mass media registration certificate dated December 7, 2006.
Series ПИ #ФС 77-26521.
Federal service for surveillance over non-violation of the legislation in the sphere of mass communications and protection of cultural heritage.
ISSN 2073-8137
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Trans-scrotal orchiectomy in localized yolk sac testicular tumors in child. how is it safe?

[Notes from practice]
Sef Din Sultan Omar Abdulwahed Mazen Sallom Firas Diab;

Testicular tumors in children are rare, founding only 1 % of all pediatric solid tumors. We report a case of 14 months old child, who was referred to us for recent scrotal painless tumefaction. The clinical examination with the US confirmed the testicular involvement of this tumor. An abnormally elevated blood level of the α-fetoprotein was decisional for the embryonic origin of this tumor. A trans-scrotal approach realized a radical orchiectomy in the bloc with a high ligation-section of the spermatic cord. The histopathology examination of this tumor has shown a yolk sac tumor. The α-fetoprotein was normalized within the first month after surgery. Regular follow up for about three years did not show any clinical or radiological signs of recurrence. This case indicated the importance of early discovery and surgery as rapid as possible. We think that in ocalized yolk sac tumors of testis (stage I) and trans-scrotal approach of radical orchiectomy alone is sufficient.

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References:
1. Ye Y., He Q., Zheng F., Guo Sh., Zhou F. [et al.] Trends of testis-sparing surgery for pediatric testicular tumors in South China. BMC Surg. 2017;17(1):31. https://doi.org/10.1186/s12893-017-0230-1
2. Flammant F., Nihoul-Fekete C., Patte C., Lemerle J. Optimal treatment of clinical stage I yolk sac tumor of the testis in children. J. Pediatric Surgery. 1986;21(2):108-111. https://doi.org/10.1016/S0022-3468(86)80059-8
3. Huddart S. N., Mann J. R., Gornall P., Pearson D., Barrett A. [et al.] The UK Children’s Cancer Study group, testicular malignant germ cell tumors, 1979-1988. J. Pediat. Surg. 1990;25(4):406-410. https://doi.org/10.1016/0022-3468(90)90381-I
4. Maizlin I. I., Dellinger M., Gow K. W., Goldin A. B., Goldfarb
M. [et al.] Testicular tumors in prepubescent patients. Journal of Pediatric Surgery. 2018;53(9):1748-1752. https://doi.org/10.1016/j.jpedsurg.2017.09.020
5. Dexeus F. H., Ogden S., Cangir A., Ro J., Logothetis C. J. Clinical Features and Management of Testicular and Extragonadal Yolk Sac Tumors. In: Nogales F. F. (eds) The Human Yolk Sac and Yolk Sac Tumors. Springer, Berlin, Heidelberg, 1993. https://doi.org/10.1007/978-3-642-77852-0_18
6. Ye Y.-L., Sun X.-Z., Zheng F.-F., Bian J., Huang Y.-P. [et al.] Clinical analysis of management of pediatric testicular germ cell tumors. Urology. 2012;79(4):892-897. https://doi.org/10.1016/j.urology.2011.07.1422

Keywords: yolk sac tumors, pediatric testicular malignancy, chemotherapy, trans-scrotal orchiectomy, infant


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Pyatigorsk State Research Institute of Balneotherapeutics
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