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About 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:

    • 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.
    • 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.

    • 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.

    Research and Clinical Trials for Childhood Testicular Tumors

    Our researchers are investigating how we can more effectively treat germ cell tumors, such as testicular tumors, according to the tumor subtype, stage, location on the body, and the child's age. Learn more about our pediatric clinical trials.

    Long-term Outcomes for Children with Testicular Tumors

    The prognosis for benign testicular tumors is usually excellent, with minimal, if any, long-term complications. If one testicle remains, we will most likely be able to keep your child’s fertility intact.

    If a child has a malignant tumor, the prognosis varies significantly depending on the extent of the disease. Prompt medical attention and aggressive therapy are essential for the best results. Continual follow-up care is equally important to monitor for side effects of radiation and chemotherapy, as well as cancer recurrence.

    Childhood Testicular Tumor Treatment Team

    Our pediatric cancer team that treats testicular tumors includes expert oncologists, urologists, and fertility doctors. They work closely to provide your child with the best possible care to treat the tumor and preserve fertility. Learn more about the specialists in our Childhood Solid Tumor Center.