What is testicular teratoma?

The testicle refers to an important part of the male reproductive system, and testicular teratoma is also a very common disease of the male testicles. Testicular teratoma is a type of teratoma or malignant cell tissue caused by different skin tissues and testicular cell tissues in the body. It usually occurs in children and has a great impact on the health of the body, so it needs to be treated in time.

What is testicular teratoma?

A testicular germ cell tumor composed of one or more different germ layer tissues (endoderm, mesoderm, and ectoderm).

Testicular teratomas before puberty are benign lesions, and 22% to 37% of patients with testicular teratomas after puberty will metastasize. Dermoid cysts are a special type of benign monoblastic teratoma, which appear as cysts rich in hair and keratin with skin appendage structures under a microscope. Testicular teratomas are mostly composed of two or more germ layers, including mucous glands of the endoderm, cartilage, bone, muscle and lymphatic tissue of the mesoderm, and squamous epithelium and neural tissue of the ectoderm.

It was previously called mature teratoma, immature teratoma, differentiated teratoma (mature type), and undifferentiated teratoma (immature type). Testicular teratoma accounts for about 2% to 9% of testicular tumors and is the most common benign tumor in children, accounting for about 50% of children with benign testicular tumors.

Causes

The cause of testicular teratoma is unclear, but it may be related to factors such as abnormal differentiation of germ cells during the embryonic period.

Clinical manifestations

The high-risk age of testicular teratoma can be divided into two age groups: children and adults. The high-risk age of testicular teratoma in children is 1 to 2 years old, and the high-risk age of testicular teratoma in adults is 25 to 35 years old. The vast majority of patients present with painless testicular lumps that are hard, nodular or irregular.

Check

Ultrasound examination is the first choice for auxiliary diagnosis of testicular lesions in clinical practice. B-ultrasound has important clinical value in judging the nature, size, location, proportion of testicular tissue occupied by the tumor and even choosing the treatment method. The B-ultrasound manifestations of testicular teratoma are clear-cut tumor boundaries, cystic solidity, cartilage, immature bone tissue or calcification in the tumor. The serum alpha-fetoprotein (AFP) level of adult patients with testicular teratoma is related to benign and malignant. The AFP level in children with testicular teratoma is within the normal range for the corresponding age group, but the blood AFP level of normal infants within 6 months varies greatly. Therefore, the high or low AFP level in infants within 6 months has no clear clinical significance.

treatment

Surgery is the first choice for the treatment of testicular teratoma. For children with testicular teratoma, testicular preservation surgery can be considered if the AFP level is normal, B-ultrasound shows the presence of normal testicular parenchyma, and intraoperative frozen pathological examination results exclude malignant tumors.

Patients with testicular dermoid cysts and testicular teratomas in children do not need other treatment after surgery. Radical orchiectomy plus retroperitoneal lymph node dissection is performed for postpubertal patients with testicular teratoma and retroperitoneal lymph node metastasis. The vast majority of teratoma metastases are consistent with the pathological type of the primary lesion, but embryonal carcinoma components are also found in the metastatic lesions of teratomas. The malignant components in distant metastatic teratomas are not well treated with chemotherapy regimens for germ cell tumors.