Testicular and Paratesticular Pathology in Children: a 12-Year Histopathological Review
Testicular and Paratesticular Pathology in Children: a 12-Year Histopathological Review
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儿童睾丸和睾丸旁病理学：12 年组织病理学回顾
DOI：
10.1007/s00268-010-0459-7
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发表时间：
2010
影响因子：
2.6
通讯作者：
D. Goh
中科院分区：
文献类型：
--
作者：
M. Marulaiah;A. Gilhotra;L. Moore;H. Boucaut;D. Goh
我们的机构是160万人口的主要儿科外科转诊中心。本研究的目的是确定儿童睾丸和睾丸旁病理的频谱和发病率在这一人群。方法对1995年8月至2007年9月间所有睾丸及睾丸旁标本的病理结果进行分析。回顾性地从计算机数据库中检索临床细节，记录年龄、表现方式、侧位和相关的腹股沟-阴囊病理。结果在12年2个月的时间里，共发现474例患者（502例标本）。睾丸和睾丸旁病变在1-2岁（11%）和11-12岁（10.5%）的患者中最常见。442例患者有非肿瘤性病理表现，其中60.4%为急性表现。最常见的非肿瘤性病理为Morgagni包虫病（42.6%）和“消失睾丸”（14.3%）。消失和萎缩的睾丸经常在1至2岁之间被发现，以左侧为主。萎缩睾丸以隐退型居多（54.8%）。11.2%发生睾丸扭转，双峰峰年龄在<1岁和13-14岁。有趣的是，睾丸扭转也更多发生在左侧（68%）。共有32例患者出现肿瘤。27例睾丸肿瘤中，恶性占55.6%（原发29.6%，继发26%），主要原发恶性肿瘤为卵黄囊瘤；最常见的良性肿瘤是表皮样囊肿和畸胎瘤。5例患者有睾丸旁肿瘤，横纹肌肉瘤占80%。结论儿童阴囊和睾丸病理的多样性是相当大的，在年龄较大（7-15岁）的儿童中，急性病理状况占大部分，而在婴儿中，不可触及的睾丸和肿瘤占大多数。有趣的是，睾丸扭转、消失睾丸和萎缩睾丸主要发生在左侧。良性睾丸肿瘤比原发性恶性肿瘤更常见。
BackgroundOur institution is the principal pediatric surgical referral center for a population of 1.6 million. The objective of this study was to determine the spectrum and incidence of pediatric testicular and paratesticular pathology in this population.MethodsPathology results of all testicular and paratesticular specimens between August 1995 to September 2007 were analyzed. Clinical details were retrieved retrospectively from the computerized database, recording age, mode of presentation, laterality, and associated inguinoscrotal pathology.ResultsOver 12 years 2 months, 474 patients (502 specimens) were identified. Testicular and paratesticular pathology was most frequent in patients aged 1–2 years (11%) and 11–12 years (10.5%). In all, 442 patients had non-neoplastic pathology, with 60.4% presenting acutely. The most common non-neoplastic pathologies were hydatid of Morgagni (42.6%) and “vanishing testis” (14.3%). Vanishing and atrophic testes were frequently explored between 1 and 2 years of age, with a left predominance. Most atrophic testes were undescended (54.8%). Testicular torsion occurred in 11.2%, with bimodal peak ages of <1 year and 13–14 years. Interestingly, testicular torsion also occurred more on the left side (68%). A total of 32 patients had neoplasms. Of 27 patients with testicular neoplasms, 55.6% were malignant (29.6% primary and 26% secondary), the principal primary malignancy was yolk sac tumor; the most common benign neoplasms were epidermoid cysts and teratomas. Five patients had paratesticular neoplasms, with rhabdomyosarcoma in 80%.ConclusionsThe variety of scrotal and testicular pathology in children is considerable, with acute pathologic conditions comprising the bulk in the older (7–15 years) children, whereas impalpable testes and neoplasms comprise most of the lesions in infants. Interestingly testicular torsion, vanishing testes, and atrophic testes occur mainly on the left side. Benign testicular neoplasms occur more frequently than primary malignancies.