Experience with the treatment of testicular yolk sac tumor in children: a report of 14 cases.

OBJECTIVE This paper discusses the optimal treatment for testicular yolk sac tumor at stage I in children. PATIENTS AND METHODS Fourteen children with testicular yolk sac tumor (including 10 cases of stage I and 4 cases of stage II) underwent high ligation of internal spermatic cord vein and orchiectomy. Among these, seven cases of stage I were below 1 year of age. Retroperitoneal lymph node dissection without postoperative systemic chemotherapy was implemented in 9 cases (5 cases of stage I and 4 cases of stage II), and only one was positive. RESULTS Among the 12 cases followed, 9 cases were alive (of these, 5 children < 1 year old, in stage I, underwent high ligation of internal spermatic cord vein and orchiectomy, with a survival time of 25 months to 10 years and 4 cases with radical retroperitoneal lymph node dissection). Three cases older than 1 year died of retroperitoneal lymph node and lung metastases. CONCLUSIONS For the high ligation of internal spermatic cord vein, orchiectomy is a kind of simple and effective treatment for children younger than 1 year with stage I, without recurrence and metastases. However, attention to the accuracy of staging and close observation are important aspects of the treatment.