Testicular Tumors | Diagnosis & Treatment

How are testicular tumors diagnosed?

The first step in treating your child is forming an accurate and complete diagnosis. Most testicular tumors are first noticed by the patient themselves, their parent, or their physician as a non-tender swelling in the scrotum.

Most of these scrotal masses, though, result from much more common problems like 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 through an examination. In addition, your child’s physician may perform or order a number of different tests including including a complete medical history or an ultrasound.

If it is determined to be a tumor, your child will receive these additional tests:

There may be other diagnostic tests that your doctor will discuss with you depending on your child's individual situation. After we complete all necessary tests, our experts meet to review and discuss what they have learned about your child's condition. Then we will meet with you and your family to discuss the results and outline the best possible treatment options.

What are the treatment options for testicular tumors?

Your child's physician will determine a specific course of treatment based on several factors, including your son's age, overall health, and medical history, as well as the size and malignancy of the tumor.

Testicular tumors, whether benign or malignant, are usually removed. Your child's treatment will almost always include surgery. A pediatric urologic surgeon will surgically remove the tumor — if the tumor is malignant, the entire affected testicle may need to be removed through a procedure known as orchiectomy.

If your son's testicular tumor is malignant, treatment may also include:

Additional surgery

When testicular cancer spreads, it first spreads to the lymph nodes at the back of the abdomen behind the intestines. Additional surgery is sometimes considered to remove these lymph nodes. This surgery can potentially be performed using minimally invasive techniques, typically robotic surgery. Depending on the findings, additional chemotherapy may be required. Surgery is also occasionally performed after chemotherapy.

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, as a direct injection into the bloodstream, or IV; or 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.

It is important to note that treatment for testicular tumors may affect fertility. Before your son begins treatment, talk with your doctors about whether their fertility is likely to be impacted — and, if so, whether fertility preservation options, such as sperm banking, should be considered.

What is the long-term outlook for children with testicular tumors?

The prognosis for benign testicular tumors is usually very good, with minimal if any long-term complications. If one testicle remains, fertility will be preserved, so your son will still be able to father children.

The prognosis for a malignant tumor can vary greatly from individual to individual and depends heavily on the extent of the disease. Prompt medical attention and aggressive therapy are important. Continual follow-up care is equally essential to monitor for side effects of radiation and chemotherapy, as well as second malignancies.

Children treated for a testicular tumor should visit a cancer survivorship clinic every year to manage disease complications, screen for recurrence, and manage late treatment side effects. A typical follow-up visit is likely to include a physical exam, laboratory testing, and imaging scans.

The David B. Perini Jr. Quality of Life Clinic at Dana-Farber provides care and advocacy for survivors of childhood cancer, conducting research on the long-term effects of cancer treatments, and offering education and support for survivors of cancer. In addition to meeting with your pediatric oncologists, your child may see one of our endocrinologists, cardiologists, neurologists, neuro-psychologists, or alternative/complementary therapy specialists. We also offer patient and family education, psychosocial assessment, genetic counseling, reproductive and fertility evaluation and counseling, and opportunities to speak with other childhood cancer survivors.