What Are Childhood Testicular Tumors?
A testicular tumor is a growth on the testicles. Testicular tumors are a type of germ cell tumor. Germ cell tumors are masses of tissue formed by immature cells that normally would have developed into mature eggs or sperm. Ninety percent of germ cell tumors are gonadal, which means they begin in the testes or ovaries' reproductive cells.
- Many testicular tumors are benign (noncancerous). While they may grow in their original location, they do not often spread to other parts of the body.
- Some testicular tumors are malignant (cancerous). They can grow aggressively and metastasize (spread) to other parts of the body, such as the lymph nodes, lungs, liver, and central nervous system, including the brain and spinal cord.
Children and teens with testicular tumors receive care from pediatric oncologists and urologists at the Rare Tumors Program, within Dana-Farber/Boston Children's Solid Tumor Center.
Because of their unique expertise in treating these types of tumors, our urologists can help identify and, when possible, avoid potential side effects – such as infertility, sexual dysfunction, or incontinence – that may result from cancer treatment. We also offer procedures that can help preserve fertility, including harvesting stem cells.
Causes and Symptoms of Childhood Testicular Tumors
When a child develops a testicular tumor, there typically isn’t any known cause. Sometimes, germ cell tumors are associated with inherited defects of the central nervous system, genitourinary tract, and lower spine. Children with undescended testicles are also at an increased risk of developing certain germ cell tumors.
Testicular tumor symptoms may include:
- Swelling in the affected testicle
- A hardened mass on the affected testicle
- Abnormal shape of the testicle or irregularity in size between testicles
- Testicular pain (though some tumors are painless)
How We Diagnose and Classify Childhood Testicular Tumors
Children, parents, and caregivers may discover a testicular tumor from noticing a growth on one of the testicles. But many growths will occur from more common problems, such as a hernia, hydrocele, testicular torsion, or inflammation of the epididymis. Your child's doctor will usually be able to distinguish a testicular tumor from these more common conditions.
To confirm a testicular tumor diagnosis, your doctor will order imaging studies and blood tests.
Your child’s medical team will review the results together to recommend the most effective treatment plan. They will discuss their recommendation and next steps with you and your family.
How We Treat Childhood Testicular Tumors
We treat testicular tumors in children, often with surgery and sometimes with chemotherapy. Whether or not your child receives both surgery and chemotherapy will depend on the tumor’s size, location, and spread.
Treatment may include:
If the tumor is malignant (cancerous), the surgeon may need to remove the entire testicle with an orchiectomy procedure. Sometimes, when the tumor spreads to the lymph nodes, we will perform minimally invasive, robotic surgery to remove them.
- Surgery: We typically try to remove the tumor initially with surgery. Your child will be in the hands of a pediatric urologic surgeon who has extensive experience with testicular tumor surgery.
- Chemotherapy: Chemotherapy is a drug that interferes with the cancer cell's ability to grow or reproduce. Chemotherapy before surgery may help shrink the tumor, making it possible to remove; used after surgery, it can help fight a cancer's recurrence. Different groups of chemotherapy drugs work in different ways to fight cancer cells and shrink tumors. Your child may receive chemotherapy:
- Orally, as a pill to swallow
- Intramuscularly, as an injection into the muscle or fat tissue
- Intravenously (IV) as a direct injection into the bloodstream
- Intrathecally, as a direct injection into the spinal column through a needle
- Supportive care: Throughout your child's treatment, our doctors use supportive care to prevent and treat infections, minimize side effects of treatment, respond to complications, and keep your child comfortable. These may include medications, dietary recommendations, and integrative therapies such as acupuncture, acupressure, and massage.
Testicular tumor treatment may affect your child’s fertility later in life. Before treatment, your care team will discuss https://www.dana-farber.org/pediatric-fertility-preservation-program/ fertility preservation options with you.
Beyond their immediate care, your child will receive continued care and support throughout survivorship. We see your child for yearly check-ups and provide complementary support with our pediatric cancer survivorship programs.