目的：青春期前睾丸肿瘤在儿童中很少见。我们旨在通过分析中国单一医疗中心的长期经验，介绍青春期前睾丸肿瘤的临床和组织学特征。
方法：对我院2005年至2015年收治的67例睾丸肿瘤患儿（≤14岁）进行回顾性分析。有关临床特征的数据，组织病理学发现,血清肿瘤标志物，治疗方法,并收集了结果。
结果：患者诊断时的中位年龄为18个月（范围3-168个月），49例(73.1%)诊断年龄小于3岁。最常见的临床表现是无痛的阴囊肿块或肿胀。关于组织学，32例（47.8%）是畸胎瘤，只有1例肿瘤表现为未成熟畸胎瘤，20例（29.9%）为卵黄囊瘤，9例（13.4%）为表皮样囊肿，1（1.5％）是Leydig细胞肿瘤，1（1.5％）是混合恶性生殖细胞肿瘤，睾丸旁肿瘤4例(8.3%)。对于生殖细胞肿瘤，卵黄囊瘤患者的术前平均血清甲胎蛋白（AFP）水平明显高于畸胎瘤患者（2,078ng/mLvs5.7ng/mL）。在所有这些病人中，37例（55.2％）接受了根治性腹股沟睾丸切除术，计划进行保留睾丸手术并在30例（44.8％）中实现。对60例患者进行了监测。经过适当的治疗，没有患者出现复发或睾丸萎缩。
结论：我们的大多数病例是良性的，最常见的组织病理学亚型是畸胎瘤。对于睾丸肿块明显且肿瘤标志物阴性的儿童，应进行保留睾丸的手术。这项研究显示，青春期前睾丸肿瘤患者比成年患者有更好的前景。
OBJECTIVE: Prepubertal testicular tumors are rare in children. We aim to present clinical and histological features of prepubertal testicular tumors through the analysis of the long-term experiences of a single medical center of
China.
METHODS: A total of 67 children (≤ 14 years) treated for testicular tumor at our institution from 2005 to 2015 were retrospectively reviewed. Data relating the clinical characteristics, histopathology findings, serum tumor markers, treatment method, and outcome were collected.
RESULTS: The patients\' median age at diagnosis was 18 months (range 3-168 months), and 49 cases (73.1%) were diagnosed at age younger than 3 years. The most common clinical presentation was a painless scrotal mass or swelling. Regarding histology, 32 (47.8%) were
teratomas and only one of these tumors presents immature
teratomas, 20 (29.9%) were yolk sac tumors, 9 (13.4%) were epidermoid cyst, 1 (1.5%) was a Leydig cell tumor, 1 (1.5%) was a mixed malignant germ cell tumor, and 4 (8.3%) were paratesticular tumors. For germ cell tumors, the mean preoperative serum α-fetoprotein (AFP) level was significantly higher in patients with yolk sac tumor than in those with
teratomas (2,078 ng/mL vs 5.7 ng/mL). Of all these patients, 37 (55.2%) were treated with radical inguinal orchiectomy and testis-sparing surgery was planned and achieved in 30 (44.8%). Surveillance was performed in 60 patients. None of the patients developed recurrence or testicular atrophy after appropriate treatment.
CONCLUSIONS: The majority of our cases were benign, with the most common histopathological subtype being teratoma. A testis-sparing procedure should be performed in children with a palpable testicular mass and negative tumor markers. This study shows a better outlook for prepuberty patient with testicular tumors than their adult counterparts.
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