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Diagnosis and Management of Testicular Tumours in Children and Adolescents

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Pediatric and Adolescent Andrology

Part of the book series: Trends in Andrology and Sexual Medicine ((TASM))

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Abstract

Testicular tumours can occur at any age but are most common in adolescents and young men. The tumours are histologically heterogeneous and can be derived from several cell types. Germ cells are by far the most common cell of origin, followed by Leydig cells and other somatic cells. Testicular tumours in children and adolescents/young adults differ from each other in many aspects, including pathogenesis and biological features, in particular the association with germ cell neoplasia in situ and isochromosome 12p of only post-pubertal TGCT. Hence the management options must be based on careful imaging, histopathological analysis, tissue and serum markers, and age-specific staging. Treatment outcomes are usually very good in any age: Testicular location contributes to an early diagnosis in many patients, and surgery alone is successful in the vast majority of patients. The extent of surgery depends on the tumour type; in malignant germ cell tumours radical orchiectomy is usually practiced, while testis-sparing surgery should be considered in boys with teratomas and in all patients with benign somatic tumours. Chemotherapy is used mainly in malignant tumours and in the disseminated disease. Young age of the survivors of testicular cancer requires close attention to the late effects of disease and treatment, hence different specialists (urologists, oncologists, paediatricians, endocrinologists, andrologists) ought to be included in the management team.

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References

  1. Moch H, Cubilla AL, Humphrey PA, Reuter VE, Ulbright TM. The 2016 WHO classification of tumours of the urinary system and male genital organs-part a: renal, penile, and testicular tumours. Eur Urol. 2016;70(1):93–105.

    Article  PubMed  Google Scholar 

  2. Oosterhuis JW, Looijenga LHJ. Human germ cell tumours from a developmental perspective. Nat Rev Cancer. 2019;19(9):522–37.

    Article  CAS  PubMed  Google Scholar 

  3. Fonseca A, Frazier AL, Shaikh F. Germ cell tumors in adolescents and young adults. J Oncol Pract. 2019;15(8):433–41.

    Article  PubMed  Google Scholar 

  4. Calaminus G, Schneider DT, von Schweinitz D, Jurgens H, Infed N, Schonberger S, et al. Age-dependent presentation and clinical course of 1465 patients aged 0 to less than 18 years with ovarian or testicular germ cell tumors; data of the MAKEI 96 protocol revisited in the light of prenatal germ cell biology. Cancers (Basel). 2020;12(3):611.

    Article  PubMed Central  Google Scholar 

  5. Skakkebaek NE. Possible carcinoma-in-situ of the testis. Lancet. 1972;2(7776):516–7.

    Article  CAS  PubMed  Google Scholar 

  6. Rajpert-De Meyts E, McGlynn KA, Okamoto K, Jewett MA, Bokemeyer C. Testicular germ cell tumours. Lancet. 2016;387(10029):1762–74.

    Article  PubMed  Google Scholar 

  7. Poynter JN, Amatruda JF, Ross JA. Trends in incidence and survival of pediatric and adolescent patients with germ cell tumors in the United States, 1975 to 2006. Cancer. 2010;116(20):4882–91.

    Article  PubMed  Google Scholar 

  8. Jørgensen N, Müller J, Giwercman A, Visfeldt J, Møller H, Skakkebaek NE. DNA content and expression of tumour markers in germ cells adjacent to germ cell tumours in childhood: probably a different origin for infantile and adolescent germ cell tumours. J Pathol. 1995;176(3):269–78.

    Google Scholar 

  9. Zhang C, Berney DM, Hirsch MS, Cheng L, Ulbright TM. Evidence supporting the existence of benign teratomas of the postpubertal testis: a clinical, histopathologic, and molecular genetic analysis of 25 cases. Am J Surg Pathol. 2013;37(6):827–35.

    Article  PubMed  Google Scholar 

  10. Mosbech CH, Rechnitzer C, Brok JS, Rajpert-De Meyts E, Hoei-Hansen CE. Recent advances in understanding the etiology and pathogenesis of pediatric germ cell tumors. J Pediatr Hematol Oncol. 2014;36(4):263–70.

    Article  CAS  PubMed  Google Scholar 

  11. Murray MJ, Nicholson JC, Coleman N. Biology of childhood germ cell tumours, focussing on the significance of microRNAs. Andrology. 2015;3(1):129–39.

    Article  CAS  PubMed  Google Scholar 

  12. Pohl HG, Shukla AR, Metcalf PD, Cilento BG, Retik AB, Bagli DJ, et al. Prepubertal testis tumors: actual prevalence rate of histological types. J Urol. 2004;172(6 Pt 1):2370–2.

    Article  PubMed  Google Scholar 

  13. Ulbright TM, Amin MB, Balzer B, Berney DM, Epstein JI, Guo C, et al. Germ cell tumours. In: Moch H, Humphrey PA, Ulbright TM, Reuter VE, editors. WHO classification of tumours of the urinary system and male genital organs. Lyon: IARC Press; 2016. p. 189–226.

    Google Scholar 

  14. Oosterhuis JW, Stoop JA, Rijlaarsdam MA, Biermann K, Smit VT, Hersmus R, et al. Pediatric germ cell tumors presenting beyond childhood? Andrology. 2015;3(1):70–7.

    Article  CAS  PubMed  Google Scholar 

  15. Murray MJ, Nicholson JC. alpha-Fetoprotein. Arch Dis Child Educ Pract Ed. 2011;96(4):141–7.

    Article  CAS  PubMed  Google Scholar 

  16. Mosbech CH, Svingen T, Nielsen JE, Toft BG, Rechnitzer C, Petersen BL, et al. Expression pattern of clinically relevant markers in paediatric germ cell- and sex-cord stromal tumours is similar to adult testicular tumours. Virchows Arch. 2014;465(5):567–77.

    Article  CAS  PubMed  Google Scholar 

  17. Skakkebaek NE, Rajpert-De Meyts E, Buck Louis GM, Toppari J, Andersson AM, Eisenberg ML, et al. Male reproductive disorders and fertility trends: influences of environment and genetic susceptibility. Physiol Rev. 2016;96(1):55–97.

    Article  CAS  PubMed  Google Scholar 

  18. van der Zwan YG, Biermann K, Wolffenbuttel KP, Cools M, Looijenga LH. Gonadal maldevelopment as risk factor for germ cell cancer: towards a clinical decision model. Eur Urol. 2015;67(4):692–701.

    Article  PubMed  Google Scholar 

  19. Jørgensen A, Lindhardt Johansen M, Juul A, Skakkebaek NE, Main KM, Rajpert-De Meyts E. Pathogenesis of germ cell neoplasia in testicular dysgenesis and disorders of sex development. Semin Cell Dev Biol. 2015;45:124–37.

    Google Scholar 

  20. Hersmus R, van Bever Y, Wolffenbuttel KP, Biermann K, Cools M, Looijenga LH. The biology of germ cell tumors in disorders of sex development. Clin Genet. 2017;91(2):292–301.

    Article  CAS  PubMed  Google Scholar 

  21. Dieckmann KP, Pichlmeier U. Clinical epidemiology of testicular germ cell tumors. World J Urol. 2004;22(1):2–14.

    Article  PubMed  Google Scholar 

  22. Akre O, Pettersson A, Richiardi L. Risk of contralateral testicular cancer among men with unilaterally undescended testis: a meta analysis. Int J Cancer. 2009;124(3):687–9.

    Article  CAS  PubMed  Google Scholar 

  23. Pettersson A, Richiardi L, Nordenskjold A, Kaijser M, Akre O. Age at surgery for undescended testis and risk of testicular cancer. N Engl J Med. 2007;356(18):1835–41.

    Article  CAS  PubMed  Google Scholar 

  24. Walsh TJ, Dall’Era MA, Croughan MS, Carroll PR, Turek PJ. Prepubertal orchiopexy for cryptorchidism may be associated with lower risk of testicular cancer. J Urol. 2007;178(4 Pt 1):1440–6; discussion 6.

    Article  PubMed  Google Scholar 

  25. Weidner IS, Moller H, Jensen TK, Skakkebaek NE. Risk factors for cryptorchidism and hypospadias. J Urol. 1999;161(5):1606–9.

    Article  CAS  PubMed  Google Scholar 

  26. Myrup C, Schnack TH, Wohlfahrt J. Correction of cryptorchidism and testicular cancer. N Engl J Med. 2007;357(8):825–7; author reply −7.

    Article  CAS  PubMed  Google Scholar 

  27. Gurney JK, Florio AA, Znaor A, Ferlay J, Laversanne M, Sarfati D, et al. International trends in the incidence of testicular cancer: lessons from 35 years and 41 countries. Eur Urol. 2019;76(5):615–23.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Rajpert-De Meyts E. Developmental model for the pathogenesis of testicular carcinoma in situ: genetic and environmental aspects. Hum Reprod Update. 2006;12(3):303–23.

    Article  Google Scholar 

  29. Hemminki K, Chen B. Familial risks in testicular cancer as aetiological clues. Int J Androl. 2006;29(1):205–10.

    Article  PubMed  Google Scholar 

  30. Litchfield K, Levy M, Huddart RA, Shipley J, Turnbull C. The genomic landscape of testicular germ cell tumours: from susceptibility to treatment. Nat Rev Urol. 2016;13(7):409–19.

    Article  CAS  PubMed  Google Scholar 

  31. de Jong B, Oosterhuis JW, Castedo SM, Vos A, te Meerman GJ. Pathogenesis of adult testicular germ cell tumors. A cytogenetic model. Cancer Genet Cytogenet. 1990;48(2):143–67.

    Article  PubMed  Google Scholar 

  32. Shen H, Shih J, Hollern DP, Wang L, Bowlby R, Tickoo SK, et al. Integrated molecular characterization of testicular germ cell tumors. Cell Rep. 2018;23(11):3392–406.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Cost NG, Lubahn JD, Adibi M, Romman A, Wickiser JE, Raj GV, et al. A comparison of pediatric, adolescent, and adult testicular germ cell malignancy. Pediatr Blood Cancer. 2014;61(3):446–51.

    Article  PubMed  Google Scholar 

  34. Hvarness T, Nielsen JE, Almstrup K, Skakkebaek NE, Rajpert-De Meyts E, Claesson MH. Phenotypic characterisation of immune cell infiltrates in testicular germ cell neoplasia. J Reprod Immunol. 2013;100(2):135–45.

    Article  CAS  PubMed  Google Scholar 

  35. Klein B, Haggeney T, Fietz D, Indumathy S, Loveland KL, Hedger M, et al. Specific immune cell and cytokine characteristics of human testicular germ cell neoplasia. Hum Reprod. 2016;31(10):2192–202.

    Article  CAS  PubMed  Google Scholar 

  36. Rajpert-De Meyts E, Nielsen JE, Skakkebaek NE, Almstrup K. Diagnostic markers for germ cell neoplasms: from placental-like alkaline phosphatase to micro-RNAs. Folia Histochem Cytobiol. 2015;53(3):177–88.

    Article  CAS  PubMed  Google Scholar 

  37. Sonne SB, Almstrup K, Dalgaard M, Juncker AS, Edsgard D, Ruban L, et al. Analysis of gene expression profiles of microdissected cell populations indicates that testicular carcinoma in situ is an arrested gonocyte. Cancer Res. 2009;69(12):5241–50.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Looijenga LH, Stoop H, de Leeuw HP, de Gouveia Brazao CA, Gillis AJ, van Roozendaal KE, et al. POU5F1 (OCT3/4) identifies cells with pluripotent potential in human germ cell tumors. Cancer Res. 2003;63(9):2244–50.

    CAS  PubMed  Google Scholar 

  39. Jones TD, Ulbright TM, Eble JN, Cheng L. OCT4: a sensitive and specific biomarker for intratubular germ cell neoplasia of the testis. Clin Cancer Res. 2004;10(24):8544–7.

    Article  CAS  PubMed  Google Scholar 

  40. Hoei-Hansen CE, Almstrup K, Nielsen JE, Brask Sonne S, Graem N, Skakkebaek NE, et al. Stem cell pluripotency factor NANOG is expressed in human fetal gonocytes, testicular carcinoma in situ and germ cell tumours. Histopathology. 2005;47(1):48–56.

    Article  CAS  PubMed  Google Scholar 

  41. Hart AH, Hartley L, Parker K, Ibrahim M, Looijenga LH, Pauchnik M, et al. The pluripotency homeobox gene NANOG is expressed in human germ cell tumors. Cancer. 2005;104(10):2092–8.

    Article  CAS  PubMed  Google Scholar 

  42. West JA, Viswanathan SR, Yabuuchi A, Cunniff K, Takeuchi A, Park IH, et al. A role for Lin28 in primordial germ-cell development and germ-cell malignancy. Nature. 2009;460(7257):909–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  43. Jacobsen GK, Norgaard-Pedersen B. Placental alkaline phosphatase in testicular germ cell tumours and in carcinoma-in-situ of the testis. An immunohistochemical study. Acta Pathol Microbiol Immunol Scand A. 1984;92(5):323–9.

    CAS  PubMed  Google Scholar 

  44. Hoei-Hansen CE, Nielsen JE, Almstrup K, Sonne SB, Graem N, Skakkebaek NE, et al. Transcription factor AP-2gamma is a developmentally regulated marker of testicular carcinoma in situ and germ cell tumors. Clin Cancer Res. 2004;10(24):8521–30.

    Article  CAS  PubMed  Google Scholar 

  45. Sonne SB, Herlihy AS, Hoei-Hansen CE, Nielsen JE, Almstrup K, Skakkebaek NE, et al. Identity of M2A (D2-40) antigen and gp36 (Aggrus, T1A-2, podoplanin) in human developing testis, testicular carcinoma in situ and germ-cell tumours. Virchows Arch. 2006;449(2):200–6.

    Article  CAS  PubMed  Google Scholar 

  46. Idrees M, Saxena R, Cheng L, Ulbright TM, Badve S. Podoplanin, a novel marker for seminoma: a comparison study evaluating immunohistochemical expression of podoplanin and OCT3/4. Ann Diagn Pathol. 2010;14(5):331–6.

    Article  PubMed  Google Scholar 

  47. Nogales FF, Quinonez E, Lopez-Marin L, Dulcey I, Preda O. A diagnostic immunohistochemical panel for yolk sac (primitive endodermal) tumours based on an immunohistochemical comparison with the human yolk sac. Histopathology. 2014;65(1):51–9.

    Article  PubMed  Google Scholar 

  48. Herszfeld D, Wolvetang E, Langton-Bunker E, Chung TL, Filipczyk AA, Houssami S, et al. CD30 is a survival factor and a biomarker for transformed human pluripotent stem cells. Nat Biotechnol. 2006;24(3):351–7.

    Article  CAS  PubMed  Google Scholar 

  49. de Jong J, Stoop H, Gillis AJ, van Gurp RJ, van de Geijn GJ, Boer M, et al. Differential expression of SOX17 and SOX2 in germ cells and stem cells has biological and clinical implications. J Pathol. 2008;215(1):21–30.

    Article  PubMed  CAS  Google Scholar 

  50. Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, et al. Guidelines on testicular cancer: 2015 update. Eur Urol. 2015;68(6):1054–68.

    Article  PubMed  Google Scholar 

  51. Isidori AM, Pozza C, Gianfrilli D, Giannetta E, Lemma A, Pofi R, et al. Differential diagnosis of nonpalpable testicular lesions: qualitative and quantitative contrast-enhanced US of benign and malignant testicular tumors. Radiology. 2014;273(2):606–18.

    Article  PubMed  Google Scholar 

  52. Lagabrielle S, Durand X, Droupy S, Izard V, Marcelli F, Huyghe E, et al. Testicular tumours discovered during infertility workup are predominantly benign and could initially be managed by sparing surgery. J Surg Oncol. 2018;118(4):630–5.

    Article  PubMed  Google Scholar 

  53. Paffenholz P, Held L, Loosen SH, Pfister D, Heidenreich A. Testis sparing surgery for benign testicular masses: diagnostics and therapeutic approaches. J Urol. 2018;200(2):353–60.

    Article  PubMed  Google Scholar 

  54. Idrees MT, Ulbright TM, Oliva E, Young RH, Montironi R, Egevad L, et al. The World Health Organization 2016 classification of testicular non-germ cell tumours: a review and update from the International Society of Urological Pathology Testis Consultation Panel. Histopathology. 2017;70(4):513–21.

    Article  PubMed  Google Scholar 

  55. Thomas JC, Ross JH, Kay R. Stromal testis tumors in children: a report from the prepubertal testis tumor registry. J Urol. 2001;166(6):2338–40.

    Article  CAS  PubMed  Google Scholar 

  56. Coppes MJ, Rackley R, Kay R. Primary testicular and paratesticular tumors of childhood. Med Pediatr Oncol. 1994;22(5):329–40.

    Article  CAS  PubMed  Google Scholar 

  57. Ross JH, Kay R. Prepubertal testis tumors. Rev Urol. 2004;6(1):11–8.

    PubMed  PubMed Central  Google Scholar 

  58. Maizlin ZV, Belenky A, Kunichezky M, Sandbank J, Strauss S. Leydig cell tumors of the testis: gray scale and color Doppler sonographic appearance. J Ultrasound Med. 2004;23(7):959–64.

    Article  PubMed  Google Scholar 

  59. Pozza C, Pofi R, Tenuta M, Tarsitano MG, Sbardella E, Fattorini G, et al. Clinical presentation, management and follow-up of 83 patients with Leydig cell tumors of the testis: a prospective case-cohort study. Hum Reprod. 2019;34(8):1389–403.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  60. Fankhauser CD, Grogg JB, Hayoz S, Wettstein MS, Dieckmann KP, Sulser T, et al. Risk factors and treatment outcomes of 1,375 patients with testicular leydig cell tumors: analysis of published case series data. J Urol. 2020;203:949–56.

    Article  PubMed  Google Scholar 

  61. Mameli C, Selvaggio G, Cerini C, Bulfamante G, Madia C, Riccipetitoni G, et al. Atypical Leydig cell tumor in children: report of 2 cases. Pediatrics. 2016;138(5):e20160151.

    Article  PubMed  Google Scholar 

  62. Liu G, Duranteau L, Carel JC, Monroe J, Doyle DA, Shenker A. Leydig-cell tumors caused by an activating mutation of the gene encoding the luteinizing hormone receptor. N Engl J Med. 1999;341(23):1731–6.

    Article  CAS  PubMed  Google Scholar 

  63. Carvajal-Carmona LG, Alam NA, Pollard PJ, Jones AM, Barclay E, Wortham N, et al. Adult Leydig cell tumors of the testis caused by germline fumarate hydratase mutations. J Clin Endocrinol Metab. 2006;91(8):3071–5.

    Google Scholar 

  64. Libe R, Fratticci A, Lahlou N, Jornayvaz FR, Tissier F, Louiset E, et al. A rare cause of hypertestosteronemia in a 68-year-old patient: a Leydig cell tumor due to a somatic GNAS (guanine nucleotide-binding protein, alpha-stimulating activity polypeptide 1)-activating mutation. J Androl. 2012;33(4):578–84.

    Article  PubMed  Google Scholar 

  65. Bozzini G, Picozzi S, Gadda F, Colombo R, Decobelli O, Palou J, et al. Long-term follow-up using testicle-sparing surgery for Leydig cell tumor. Clin Genitourin Cancer. 2013;11(3):321–4.

    Article  PubMed  Google Scholar 

  66. Elert A, Olbert P, Hegele A, Barth P, Hofmann R, Heidenreich A. Accuracy of frozen section examination of testicular tumors of uncertain origin. Eur Urol. 2002;41(3):290–3.

    Article  PubMed  Google Scholar 

  67. Giannarini G, Mogorovich A, Bardelli I, Manassero F, Selli C. Testis-sparing surgery for benign and malignant tumors: a critical analysis of the literature. Indian J Urol. 2008;24(4):467–74.

    Article  PubMed  PubMed Central  Google Scholar 

  68. Sheynkin YR, Sukkarieh T, Lipke M, Cohen HL, Schulsinger DA. Management of nonpalpable testicular tumors. Urology. 2004;63(6):1163–7; discussion 7.

    Article  PubMed  Google Scholar 

  69. Kim I, Young RH, Scully RE. Leydig cell tumors of the testis: a clinicopathological analysis of 40 cases and review of the literature. Am J Surg Pathol. 1985;9(3):177–92.

    Article  CAS  PubMed  Google Scholar 

  70. Billings SD, Roth LM, Ulbright TM. Microcystic Leydig cell tumors mimicking yolk sac tumor: a report of four cases. Am J Surg Pathol. 1999;23(5):546–51.

    Article  CAS  PubMed  Google Scholar 

  71. Ulbright TM, Srigley JR, Hatzianastassiou DK, Young RH. Leydig cell tumors of the testis with unusual features: adipose differentiation, calcification with ossification, and spindle-shaped tumor cells. Am J Surg Pathol. 2002;26(11):1424–33.

    Article  PubMed  Google Scholar 

  72. Al-Agha OM, Axiotis CA. An in-depth look at Leydig cell tumor of the testis. Arch Pathol Lab Med. 2007;131(2):311–7.

    Article  PubMed  Google Scholar 

  73. Colecchia M, Nistal M, Gonzalez-Peramato P, Carmignani L, Salvioni R, Nicolai N, et al. Leydig cell tumor and hyperplasia: a review. Anal Quant Cytol Histol. 2007;29(3):139–47.

    PubMed  Google Scholar 

  74. McCluggage WG, Shanks JH, Arthur K, Banerjee SS. Cellular proliferation and nuclear ploidy assessments augment established prognostic factors in predicting malignancy in testicular Leydig cell tumours. Histopathology. 1998;33(4):361–8.

    Article  CAS  PubMed  Google Scholar 

  75. Reznik Y, Rieu M, Kuhn JM, Mandard JC, Bottet P, Lemonnier D, et al. Luteinizing hormone regulation by sex steroids in men with germinal and Leydig cell tumours. Clin Endocrinol. 1993;38(5):487–93.

    Article  CAS  Google Scholar 

  76. Ortiz DJ, Silva J, Abad M, Garcia-Macias MC, Bulon YA. Leydig cell tumour of the testis: cytological findings on fine needle aspiration. Cytopathology. 1999;10(3):217–8.

    CAS  PubMed  Google Scholar 

  77. McCluggage WG, Shanks JH, Whiteside C, Maxwell P, Banerjee SS, Biggart JD. Immunohistochemical study of testicular sex cord-stromal tumors, including staining with anti-inhibin antibody. Am J Surg Pathol. 1998;22(5):615–9.

    Article  CAS  PubMed  Google Scholar 

  78. Augusto D, Leteurtre E, De La Taille A, Gosselin B, Leroy X. Calretinin: a valuable marker of normal and neoplastic Leydig cells of the testis. Appl Immunohistochem Mol Morphol. 2002;10(2):159–62.

    Article  CAS  PubMed  Google Scholar 

  79. Busam KJ, Iversen K, Coplan KA, Old LJ, Stockert E, Chen YT, et al. Immunoreactivity for A103, an antibody to melan-a (Mart-1), in adrenocortical and other steroid tumors. Am J Surg Pathol. 1998;22(1):57–63.

    Article  CAS  PubMed  Google Scholar 

  80. Iczkowski KA, Bostwick DG, Roche PC, Cheville JC. Inhibin a is a sensitive and specific marker for testicular sex cord-stromal tumors. Mod Pathol. 1998;11(8):774–9.

    CAS  PubMed  Google Scholar 

  81. Pierre P, Despert F, Tranquart F, Coutant R, Tardy V, Kerlan V, et al. Adrenal rest tissue in gonads of patients with classical congenital adrenal hyperplasia: multicenter study of 45 French male patients. Ann Endocrinol (Paris). 2012;73(6):515–22.

    Article  Google Scholar 

  82. Rutgers JL, Young RH, Scully RE. The testicular “tumor” of the adrenogenital syndrome. A report of six cases and review of the literature on testicular masses in patients with adrenocortical disorders. Am J Surg Pathol. 1988;12(7):503–13.

    Article  CAS  PubMed  Google Scholar 

  83. Ashley RA, McGee SM, Isotaolo PA, Kramer SA, Cheville JC. Clinical and pathological features associated with the testicular tumor of the adrenogenital syndrome. J Urol. 2007;177(2):546–9; discussion 9.

    Article  PubMed  Google Scholar 

  84. Aycan Z, Bas VN, Cetinkaya S, Yilmaz Agladioglu S, Tiryaki T. Prevalence and long-term follow-up outcomes of testicular adrenal rest tumours in children and adolescent males with congenital adrenal hyperplasia. Clin Endocrinol. 2013;78(5):667–72.

    Article  Google Scholar 

  85. Grogg J, Schneider K, Bode PK, Kranzbuhler B, Eberli D, Sulser T, et al. Sertoli cell tumors of the testes: systematic literature review and meta-analysis of outcomes in 435 patients. Oncologist. 2020;25(7):585–90.

    Google Scholar 

  86. Gabrilove JL, Freiberg EK, Leiter E, Nicolis GL. Feminizing and non-feminizing Sertoli cell tumors. J Urol. 1980;124(6):757–67.

    Article  CAS  PubMed  Google Scholar 

  87. Goswitz JJ, Pettinato G, Manivel JC. Testicular sex cord-stromal tumors in children: clinicopathologic study of sixteen children with review of the literature. Pediatr Pathol Lab Med. 1996;16(3):451–70.

    Article  CAS  PubMed  Google Scholar 

  88. Necchi A, Bratslavsky G, Shapiro O, Elvin JA, Vergilio JA, Killian JK, et al. Genomic features of metastatic testicular sex cord stromal tumors. Eur Urol Focus. 2019;5(5):748–55.

    Article  PubMed  Google Scholar 

  89. Young S, Gooneratne S, Straus FH, Zeller WP, Bulun SR, Rosenthal IM. Feminizing Sertoli cell tumors in boys with Peutz-Jeghers syndrome. Am J Surg Pathol. 1995;19(1):50–8.

    Article  CAS  PubMed  Google Scholar 

  90. Young RH, Koelliker DD, Scully RE. Sertoli cell tumors of the testis, not otherwise specified: a clinicopathologic analysis of 60 cases. Am J Surg Pathol. 1998;22(6):709–21.

    Article  CAS  PubMed  Google Scholar 

  91. Kommoss F, Oliva E, Bittinger F, Kirkpatrick CJ, Amin MB, Bhan AK, et al. Inhibin-alpha CD99, HEA125, PLAP, and chromogranin immunoreactivity in testicular neoplasms and the androgen insensitivity syndrome. Hum Pathol. 2000;31(9):1055–61.

    Article  CAS  PubMed  Google Scholar 

  92. Kao CS, Cornejo KM, Ulbright TM, Young RH. Juvenile granulosa cell tumors of the testis: a clinicopathologic study of 70 cases with emphasis on its wide morphologic spectrum. Am J Surg Pathol. 2015;39(9):1159–69.

    Article  PubMed  Google Scholar 

  93. Talerman A, Dlemarre JF. Gonadoblastoma associated with embryonal carcinoma in an anatomically normal man. J Urol. 1975;113(3):355–9.

    Article  CAS  PubMed  Google Scholar 

  94. Scully RE. Gonadoblastoma. A review of 74 cases. Cancer. 1970;25(6):1340–56.

    Article  CAS  PubMed  Google Scholar 

  95. Burger T, Schildhaus HU, Inniger R, Hansen J, Mayer P, Schweyer S, et al. Ovarian-type epithelial tumours of the testis: immunohistochemical and molecular analysis of two serous borderline tumours of the testis. Diagn Pathol. 2015;10:118.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  96. Dogra VS, Gottlieb RH, Oka M, Rubens DJ. Sonography of the scrotum. Radiology. 2003;227(1):18–36.

    Article  PubMed  Google Scholar 

  97. Geraghty MJ, Lee FT Jr, Bernsten SA, Gilchrist K, Pozniak MA, Yandow DJ. Sonography of testicular tumors and tumor-like conditions: a radiologic-pathologic correlation. Crit RevDiagn Imaging. 1998;39(1):1–63.

    Article  CAS  Google Scholar 

  98. Thava V, Cooper N, Egginton JA. Yolk sac tumour of the testis in childhood. Br J Radiol. 1992;65(780):1142–4.

    Article  CAS  PubMed  Google Scholar 

  99. Pozza C, Gianfrilli D, Fattorini G, Giannetta E, Barbagallo F, Nicolai E, et al. Diagnostic value of qualitative and strain ratio elastography in the differential diagnosis of non-palpable testicular lesions. Andrology. 2016;4(6):1193–203.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  100. Manganaro L, Saldari M, Pozza C, Vinci V, Gianfrilli D, Greco E, et al. Dynamic contrast-enhanced and diffusion-weighted MR imaging in the characterisation of small, non-palpable solid testicular tumours. Eur Radiol. 2018;28(2):554–64.

    Article  PubMed  Google Scholar 

  101. Manganaro L, Vinci V, Pozza C, Saldari M, Gianfrilli D, Pofi R, et al. A prospective study on contrast-enhanced magnetic resonance imaging of testicular lesions: distinctive features of Leydig cell tumours. Eur Radiol. 2015;25(12):3586–95.

    Article  PubMed  Google Scholar 

  102. Krone KD, Carroll BA. Scrotal ultrasound. Radiol Clin N Am. 1985;23(1):121–39.

    Article  CAS  PubMed  Google Scholar 

  103. Milose JC, Filson CP, Weizer AZ, Hafez KS, Montgomery JS. Role of biochemical markers in testicular cancer: diagnosis, staging, and surveillance. Open Access J Urol. 2011;4:1–8.

    PubMed  PubMed Central  Google Scholar 

  104. Ehrlich Y, Beck SD, Foster RS, Bihrle R, Einhorn LH. Serum tumor markers in testicular cancer. Urol Oncol. 2013;31(1):17–23.

    Article  CAS  PubMed  Google Scholar 

  105. Dieckmann KP, Richter-Simonsen H, Kulejewski M, Ikogho R, Zecha H, Anheuser P, et al. Testicular germ-cell tumours: a descriptive analysis of clinical characteristics at first presentation. Urol Int. 2018;100(4):409–19.

    Article  CAS  PubMed  Google Scholar 

  106. Murray MJ, Huddart RA, Coleman N. The present and future of serum diagnostic tests for testicular germ cell tumours. Nat Rev Urol. 2016;13(12):715–25.

    Article  CAS  PubMed  Google Scholar 

  107. Nappi L, Nichols C. MicroRNAs as biomarkers for germ cell tumors. Urol Clin North Am. 2019;46(3):449–57.

    Article  PubMed  Google Scholar 

  108. Almstrup K, Lobo J, Morup N, Belge G, Rajpert-De Meyts E, Looijenga LHJ, et al. Application of miRNAs in the diagnosis and monitoring of testicular germ cell tumours. Nat Rev Urol. 2020:17;201-213.

    Google Scholar 

  109. Bandak M, Jorgensen N, Juul A, Lauritsen J, Gundgaard Kier MG, Mortensen MS, et al. Preorchiectomy Leydig cell dysfunction in patients with testicular cancer. Clin Genitourin Cancer. 2017;15(1):e37–43.

    Article  PubMed  Google Scholar 

  110. Zarrilli S, Lombardi G, Paesano L, Di Somma C, Colao A, Mirone V, et al. Hormonal and seminal evaluation of Leydig cell tumour patients before and after orchiectomy. Andrologia. 2000;32(3):147–54.

    Article  CAS  PubMed  Google Scholar 

  111. Mieritz MG, Raket LL, Hagen CP, Nielsen JE, Talman ML, Petersen JH, et al. A longitudinal study of growth, sex steroids, and IGF-1 in boys with physiological gynecomastia. J Clin Endocrinol Metab. 2015;100(10):3752–9.

    Article  CAS  PubMed  Google Scholar 

  112. Sansone A, Romanelli F, Sansone M, Lenzi A, Di Luigi L. Gynecomastia and hormones. Endocrine. 2017;55(1):37–44.

    Article  CAS  PubMed  Google Scholar 

  113. Kanakis GA, Nordkap L, Bang AK, Calogero AE, Bartfai G, Corona G, et al. EAA clinical practice guidelines-gynecomastia evaluation and management. Andrology. 2019;7(6):778–93.

    Article  CAS  PubMed  Google Scholar 

  114. Honecker F, Aparicio J, Berney D, Beyer J, Bokemeyer C, Cathomas R, et al. ESMO consensus conference on testicular germ cell cancer: diagnosis, treatment and follow-up. Ann Oncol. 2018;29(8):1658–86.

    Article  CAS  PubMed  Google Scholar 

  115. Cornejo KM, Frazier L, Lee RS, Kozakewich HP, Young RH. Yolk sac tumor of the testis in infants and children: a clinicopathologic analysis of 33 cases. Am J Surg Pathol. 2015;39(8):1121–31.

    Article  PubMed  Google Scholar 

  116. Sobin L, Gospodarowicz MK, Wittekind C, editors. International Union Against Cancer (UICC) TNM classification of malignant tumors. 7th ed. Oxford, UK: Wiley-Blakwell; 2009.

    Google Scholar 

  117. International Germ Cell Consensus Classification: a prognostic factor-based staging system for metastatic germ cell cancers. J Clin Oncol. 1997;15(2):594–603.

    Google Scholar 

  118. Frazier AL, Hale JP, Rodriguez-Galindo C, Dang H, Olson T, Murray MJ, et al. Revised risk classification for pediatric extracranial germ cell tumors based on 25 years of clinical trial data from the United Kingdom and United States. J Clin Oncol. 2015;33(2):195–201.

    Article  CAS  PubMed  Google Scholar 

  119. Skakkebaek NE, Rajpert-De Meyts E, Main KM. Testicular dysgenesis syndrome: an increasingly common developmental disorder with environmental aspects. Hum Reprod. 2001;16(5):972–8.

    Article  CAS  PubMed  Google Scholar 

  120. Rives N, Perdrix A, Hennebicq S, Saias-Magnan J, Melin MC, Berthaut I, et al. The semen quality of 1158 men with testicular cancer at the time of cryopreservation: results of the French National CECOS Network. J Androl. 2012;33(6):1394–401.

    Article  PubMed  Google Scholar 

  121. Williams DH. Sperm banking and the cancer patient. Ther Adv Urol. 2010;2(1):19–34.

    Article  PubMed  PubMed Central  Google Scholar 

  122. Djaladat H, Burner E, Parikh PM, Beroukhim Kay D, Hays K. The association between testis cancer and semen abnormalities before orchiectomy: a systematic review. J Adolesc Young Adult Oncol. 2014;3(4):153–9.

    Article  PubMed  PubMed Central  Google Scholar 

  123. Fode M, Ohl DA, Sonksen J. A step-wise approach to sperm retrieval in men with neurogenic anejaculation. Nat Rev Urol. 2015;12(11):607–16.

    Article  PubMed  Google Scholar 

  124. Gat I, Toren A, Hourvitz A, Raviv G, Band G, Baum M, et al. Sperm preservation by electroejaculation in adolescent cancer patients. Pediatr Blood Cancer. 2014;61(2):286–90.

    Article  PubMed  Google Scholar 

  125. Berookhim BM, Mulhall JP. Outcomes of operative sperm retrieval strategies for fertility preservation among males scheduled to undergo cancer treatment. Fertil Steril. 2014;101(3):805–11.

    Article  PubMed  Google Scholar 

  126. Onofre J, Baert Y, Faes K, Goossens E. Cryopreservation of testicular tissue or testicular cell suspensions: a pivotal step in fertility preservation. Hum Reprod Update. 2016;22(6):744–61.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  127. Sabanegh ES Jr, Ragheb AM. Male fertility after cancer. Urology. 2009;73(2):225–31.

    Article  PubMed  Google Scholar 

  128. Ku JY, Park NC, Jeon TG, Park HJ. Semen analysis in cancer patients referred for sperm cryopreservation before chemotherapy over a 15-year period in Korea. World J Mens Health. 2015;33(1):8–13.

    Article  PubMed  PubMed Central  Google Scholar 

  129. Heidenreich A, Pfister D. Retroperitoneal lymphadenectomy and resection for testicular cancer: an update on best practice. Ther Adv Urol. 2012;4(4):187–205.

    Article  PubMed  PubMed Central  Google Scholar 

  130. Schrader M, Muller M, Sofikitis N, Straub B, Krause H, Miller K. “Onco-tese”: testicular sperm extraction in azoospermic cancer patients before chemotherapy-new guidelines? Urology. 2003;61(2):421–5.

    Article  CAS  PubMed  Google Scholar 

  131. Furuhashi K, Ishikawa T, Hashimoto H, Yamada S, Ogata S, Mizusawa Y, et al. Onco-testicular sperm extraction: testicular sperm extraction in azoospermic and very severely oligozoospermic cancer patients. Andrologia. 2013;45(2):107–10.

    Article  CAS  PubMed  Google Scholar 

  132. Tempest HG, Ko E, Chan P, Robaire B, Rademaker A, Martin RH. Sperm aneuploidy frequencies analysed before and after chemotherapy in testicular cancer and Hodgkin’s lymphoma patients. Hum Reprod. 2008;23(2):251–8.

    Article  CAS  PubMed  Google Scholar 

  133. Kerns SL, Fung C, Monahan PO, Ardeshir-Rouhani-Fard S, Abu Zaid MI, Williams AM, et al. Cumulative burden of morbidity among testicular cancer survivors after standard cisplatin-based chemotherapy: a multi-institutional study. J Clin Oncol. 2018;36(15):1505–12.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  134. Mykletun A, Dahl AA, Haaland CF, Bremnes R, Dahl O, Klepp O, et al. Side effects and cancer-related stress determine quality of life in long-term survivors of testicular cancer. J Clin Oncol. 2005;23(13):3061–8.

    Article  PubMed  Google Scholar 

  135. Orre IJ, Fossa SD, Murison R, Bremnes R, Dahl O, Klepp O, et al. Chronic cancer-related fatigue in long-term survivors of testicular cancer. J Psychosom Res. 2008;64(4):363–71.

    Article  PubMed  Google Scholar 

  136. Wiechno P, Demkow T, Kubiak K, Sadowska M, Kaminska J. The quality of life and hormonal disturbances in testicular cancer survivors in cisplatin era. Eur Urol. 2007;52(5):1448–54.

    Article  PubMed  Google Scholar 

  137. Baniel J, Sella A. Complications of retroperitoneal lymph node dissection in testicular cancer: primary and post-chemotherapy. Semin Surg Oncol. 1999;17(4):263–7.

    Article  CAS  PubMed  Google Scholar 

  138. Heidenreich A, Thuer D, Polyakov S. Postchemotherapy retroperitoneal lymph node dissection in advanced germ cell tumours of the testis. Eur Urol. 2008;53(2):260–72.

    Article  PubMed  Google Scholar 

  139. Mishra SI, Scherer RW, Snyder C, Geigle P, Gotay C. Are exercise programs effective for improving health-related quality of life among cancer survivors? A systematic review and meta-analysis. Oncol Nurs Forum. 2014;41(6):E326–42.

    Article  PubMed  PubMed Central  Google Scholar 

  140. Chao C, Bhatia S, Xu L, Cannavale KL, Wong FL, Huang PS, et al. Incidence, risk factors, and mortality associated with second malignant neoplasms among survivors of adolescent and young adult cancer. JAMA Netw Open. 2019;2(6):e195536.

    Article  PubMed  PubMed Central  Google Scholar 

  141. Fossa SD, Gilbert E, Dores GM, Chen J, McGlynn KA, Schonfeld S, et al. Noncancer causes of death in survivors of testicular cancer. J Natl Cancer Inst. 2007;99(7):533–44.

    Article  PubMed  Google Scholar 

  142. Kvammen O, Myklebust TA, Solberg A, Moller B, Klepp OH, Fossa SD, et al. Long-term relative survival after diagnosis of testicular germ cell tumor. Cancer Epidemiol Biomark Prev. 2016;25(5):773–9.

    Article  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Medical Pathophysiology, ‘Sapienza’ University of Rome, Rome, Italy

    Andrea M. Isidori & Francesco Carlomagno

  2. Department of Growth & Reproduction, Copenhagen University Hospital (Rigshospitalet), Copenhagen, Denmark

    Ewa Rajpert-De Meyts

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  1. Andrea M. Isidori
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  2. Francesco Carlomagno
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  3. Ewa Rajpert-De Meyts
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Correspondence to Ewa Rajpert-De Meyts .

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  1. Department of Medicine, Unit of Andrology and Reproductive Medicine, University of Padua, Padova, Italy

    Carlo Foresta

  2. Department of Experimental Medicine, Section of Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, Roma, Italy

    Daniele Gianfrilli

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Isidori, A.M., Carlomagno, F., Rajpert-De Meyts, E. (2021). Diagnosis and Management of Testicular Tumours in Children and Adolescents. In: Foresta, C., Gianfrilli, D. (eds) Pediatric and Adolescent Andrology. Trends in Andrology and Sexual Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-80015-4_13

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