Embryonal adenocarcinoma in the prepubertal testis. A clinicopathologic study of 18 cases.

TLDR: The clinicopathologic findings in 18 children with embryonal adenocarcinoma of the testis seen at the Memorial and James Ewing Hospitals are reviewed and discussed in the light of current concepts of treatment and histogenesis, with particular reference to the occurrence of solitary metastasis.

Abstract: The clinicopathologic findings in 18 children with embryonal adenocarcinoma of the testis seen at the Memorial and James Ewing Hospitals are reviewed and discussed in the light of current concepts of treatment and histogenesis. the majority of these uncommon tumors occur prior to 4 years of age, but they are occasionally seen in older children and in adults, either in a pure form or in conjunction with other germinal tumor patterns. This series includes 2 cases in which, for the first time, distinct teratomatous elements are seen in association with the embryonal adenocarcinoma in prepubertal testes. Presenting as an asymptomatic testicular mass, this tumor requires careful differential diagnosis from the more common causes of scrotal enlargement. Two unique cases in which maldescent was present are reported; in one of these, bilaterality was suggested. Prophylactic retroperitoneal lymph node dissections were carried out in 8 cases, and, in all cases, the nodes were negative. Factors affecting survival are discussed with particular reference to the occurrence of solitary metastasis. Five of the 18 patients died of their disease. the highly reliable correlation of pathologic stage with clinical stage in these tumors renders questionable the need for retroperitoneal lymph node dissection in children with this tumor, although the small number of cases precludes final resolution of this question. the term “embryonal adenocarcinoma” is preferred for these childhood testis tumors which are felt to represent a single germinal tumor of varying form which differs from the adult émbryonal carcinoma in appearance and behavior although probably not in histogenesis.