Clinical evaluation of pediatric testicular masses

Abstract

Scrotal pathologies are frequently seen in pediatric population. There are plenty of diseases that can be seen with similar clinical findings. These are generally benign lesions that can be diagnosed by simple physical examination and radiological techniques. Most of the clinicians are familiar with these diseases and are able to manage them. The problematic diseases of scrotum are testicular masses. They are seen rarely, but when they are diagnosed, they cause anxiety in both family and clinician. This may cause overtreatment of these diseases, as it is proposed to be in adult patients. However, these tumors have different characteristics in pediatric population. They also differ between prepubertal and postpubertal pediatric patients. Like histopathological properties, malignancy potentials of testis tumors are different in prepubertal ages. Benign tumors are much more frequent in pediatric group. This gives the clinician an opportunity for conservative treatment. Testis sparing surgery which is performed rarely for adult testis tumors, can be very efficient for prepubertal patients. According to oncologic principles, conservative surgery must be performed only for absolutely indicated patients. For this reason, clinicians must have the idea how to differentiate benign and malign testicular masses. In this review, we summarized the most common testicular pathologies in children, and tried to point out the principles of evaluating, differentiating and treating benign and malignant testicular masses of pediatric age group.