How are testicular teratomas treated?

Updated: Nov 22, 2019
  • Author: Chad A Hamilton, MD; Chief Editor: Yukio Sonoda, MD  more...
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Answer

Testicular teratomas traditionally have been treated by simple or radical orchiectomy. More recently, conservative excision by enucleation also has been recommended for prepubertal teratomas of the testis. [20, 61]  Several studies have failed to demonstrate negative sequelae for prepubertal testicular teratomas, so testis-sparing procedures are appropriate. [62, 63] Patients should be counseled regarding the following risks [38, 34] :

  • Inadequate sampling
  • Incorrect diagnosis by frozen section
  • Tumor spillage and seeding
  • Unidentified microinvasive disease

The risk of malignancy increases with maturation of the testes, and this is a significant concern in children at or near puberty. In this group, areas of normal surrounding testicular tissue should be excised and sent for frozen section. If frozen section reveals areas of maturity, proceeding to orchiectomy is recommended. Enucleation or partial orchiectomy for teratoma in pubertal or adult males is not recommended. [34]


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