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Prepubertal Testicular Teratomas and Epidermoid Cysts: Comparison of Clinical and Sonographic Features

Authors
 Min Yung Chang  ;  Hyun Joo Shin  ;  Hyun Gi Kim  ;  Myung Joon Kim  ;  Mi Jung Lee 
Citation
 JOURNAL OF ULTRASOUND IN MEDICINE, Vol.34(10) : 1745-1751, 2015 
Journal Title
 JOURNAL OF ULTRASOUND IN MEDICINE 
ISSN
 0278-4297 
Issue Date
2015
MeSH
Child, Preschool ; Diagnosis, Differential ; Epidermal Cyst/diagnosis* ; Humans ; Infant ; Infant, Newborn ; Male ; Physical Examination/methods ; Teratoma/diagnosis* ; Testicular Neoplasms/diagnosis* ; Ultrasonography/methods*
Keywords
child ; epidermoid cyst ; genitourinary ultrasound ; pediatric ultrasound ; sonography ; teratoma ; testis
Abstract
OBJECTIVES: To evaluate clinical and sonographic features of testicular teratomas and epidermoid cysts in children and to assess differential points of immature teratomas from benign counterparts. METHODS: We retrospectively reviewed testicular teratomas and epidermoid cysts in children. Age at surgery, α-fetoprotein (AFP) level, and sonographic findings, including components (mainly cystic, mainly solid, or mixed), presence of calcification, and size, were reviewed. RESULTS: Nineteen cases were included, with 10 mature teratomas, 3 immature teratomas, and 6 epidermoid cysts. On sonography, most of the teratomas (n = 9) had mixed components, with 2 mainly cystic and 2 mainly solid lesions. The 2 mainly cystic teratomas underwent follow-up sonography and showed component changes to mainly solid. Compared to epidermoid cysts, teratomas were larger (P = .029) with less cystic components (P = .046). All 3 immature teratomas showed mixed components with calcification. In differentiating immature from benign teratomas, immature teratomas were larger (P= .047) in younger children (P= .008) with higher AFP levels (P= .023). The optimal cutoff values for diagnosing immature teratomas were 8 months of age, 23 ng/mL in AFP level, and 2.5 cm in size, with 100% sensitivity and 89.5% accuracy rates. However, sonographic features, including tumor components and presence of calcification, were not helpful for differentiating immature teratomas. CONCLUSIONS: Testicular masses in children younger than 8 months with AFP levels higher than 23 ng/mL and size larger than 2.5 cm need to be considered for orchiectomy rather than testis-sparing tumorectomy because of the increased frequency of immature teratomas versus mature teratomas or epidermoid cysts.
Full Text
http://www.jultrasoundmed.org/content/34/10/1745
DOI
10.7863/ultra.15.14.09032
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myung Joon(김명준) ORCID logo https://orcid.org/0000-0002-4608-0275
Kim, Hyun Gi(김현지)
Shin, Hyun Joo(신현주) ORCID logo https://orcid.org/0000-0002-7462-2609
Lee, Mi-Jung(이미정) ORCID logo https://orcid.org/0000-0003-3244-9171
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141216
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