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

 Min Yung Chang  ;  Hyun Joo Shin  ;  Hyun Gi Kim  ;  Myung Joon Kim  ;  Mi Jung Lee 
 Journal of Ultrasound in Medicine, Vol.34(10) : 1745-1751, 2015 
Journal Title
 Journal of Ultrasound in Medicine 
Issue Date
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.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
김명준(Kim, Myung Joon) ORCID logo https://orcid.org/0000-0002-4608-0275
김현지(Kim, Hyun Gi)
신현주(Shin, Hyun Joo) ORCID logo https://orcid.org/0000-0002-7462-2609
이미정(Lee, Mi-Jung) ORCID logo https://orcid.org/0000-0003-3244-9171
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