Testicular cancer in adolescents: clinicopathological and immunohistochemical aspects

Testicular germ cell malignancies have a low prevalence among pediatric neoplasia, presenting a bimodal distribution, the two peaks being around the age of five years and postpuberty. Early identification of these types of solid tumors is extremely important, since the prognosis has improved significantly in recent decades through the multimodal diagnostic and therapeutic approach. Our study refers to two cases of testicular neoplasm diagnosed in the postpubertal period. The two adolescents were diagnosed in the Department of Oncopediatrics, in a short interval (February and March 2023). The diagnostic process was based on biological dosing, histopathological (HP) and immunohistochemical examination of orchiectomy specimens and imaging evaluations (computed tomography and magnetic resonance imaging). Following the investigations described, non-seminomatous germ cell tumors were identified in both cases. In the first patient, the tumor was classified in stage IB, while the second patient presented with advanced stage disease, presenting pulmonary, hepatic and ganglia metastases, being classified in stage IIIC. In both patients, chemotherapy was initiated according to current therapeutic protocols. Testicular tumors are a rare pathology with a specific clinical-biological and HP picture that require a multimodal approach (pediatric oncologist, pediatric surgeon, pathologist, radiologist), and for which the prognosis differs depending on the diagnosis stage and the detected histological type.