Tumors of the Genitourinary Tract in Children
While they are very rare, our experienced pediatric urologists at Georgia Urology treat patients with tumors which occur in organs of the male or female genital or urinary tract in children. These tumors may be benign or malignant (cancerous).
Tumors in genital organs of children include tumors of the
- Paratesticular soft tissue
Tumors in the urinary tract of children include tumors of the
- Prostate gland
These tumors are rare and if they prove to be cancerous, the treatment is complex. Frequently, management involves a team of specialists several therapies. In addition to our pediatric urologists, the team may consist of a pediatric diagnostic radiologist, a pediatric general surgeon, a pediatric oncologist, and a pediatric radiotherapist.
Testis tumors in children may be benign or malignant. The most common benign tumor is an epidermoid cyst; the most common malignant tumor is a germ cell tumor. Epidermoid cysts are lined by cells which look like skin cells (epidermis). Germ cells are the cells which differentiate into sperm (testicle) or egg (ovary) cells in the post-pubertal male/female. Several types of testicular germ cell tumors have been described, the most common being termed a yolk sac tumor due to its resemblance to cells found in the embryonic yolk sac.
Most testicular tumors occur in pre-school age children (peak age ~ 2yr) but may occur at any age. They most commonly present as a hard painless mass in the scrotal sac. They must be distinguished from several other more common conditions which will cause swelling or enlargement of the scrotal sac such as hydroceles, inguinal hernias, testicular torsion, and epididymitis (discussed elsewhere).
If a child develops a hard, painless mass in the scrotal sac a scrotal ultrasound examination may be very useful to clarify impressions of the physical examination – is the enlargement/tumor in or next to the testicle, is it cystic or solid, does it have blood flow to it. These features help determine what the tumor is most likely to be.
Germ cells tumors often secrete a protein which is measurable in the blood. If there is strong suspicion from the examination and diagnostic tests that the tumor may be a malignancy it must be surgically removed or biopsied.
Treatment of testicular malignancies will often include subsequent (following surgery) chemotherapy and occasionally radiation therapy (X-ray treatment). They are very responsive to treatment and cure rates are very high. Benign tumors generally require no further treatment beyond excision.