Multidisciplinary evaluation improves prevalence of testis-sparing surgery in children with testicular benign tumors: a cross-section study

To investigate the profile of children with benign testicular tumors and compare the prevalence of testis-sparing surgery (TSS) in two periods. Data from children with testicular benign tumors who were admitted to our hospital from January 2004 to March 2024 were retrospectively retrieved and multidisciplinary evaluation was administered beginning in 2018. Statistical analysis was performed to analyze the factors associated with TSS. There were 51 children with benign tumors, including 24 with teratomas, 21 with epidermoid cysts, 3 with adenomas, 2 with mesothelial cysts and 1 with sex cord–stromal tumor. Four patients had elevated serum AFP levels, and preoperative ultrasound examination of 5 patients revealed malignant tumors with normal tumor markers. Twenty-six patients underwent TSS, and frozen-section examination was performed in 18 patients, which was consistent with the final pathological results. Since 2018, the proportion of TSS increased significantly compared with that in the previous period(19/25 vs. 7/26, p < 0.001). Multiparameter analysis revealed that tumor size and period were significantly associated with TSS (p = 0.002 and 0.002, respectively). The median follow-up time was 44 months, and none of the interviewed patients experienced any complications. The median sizes of the healthy testis and the involved testis were 26 mm and 23 mm, respectively. A > 10 mm difference in testis size was detected in 2 patients. The overtreatment of pediatric testicular benign tumors is not uncommon. A comprehensive evaluation should be conducted, and testis-sparing surgery should be considered if feasible. Children seem to have similar sized testes after testis-sparing surgery.