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Objective: To study the clinical characteristics of yolk sac tumor of the testis with concomitant testicular hydrocele in children and the association between the two conditions in order to improve the diagnosis and treatment of the disease., Methods: We retrospectively analyzed the clinical data of 7 cases of stage-I yolk sac tumor of the testis with concomitant testicular hydrocele. The patients ranged in age from 6 to 14 (mean 11) months. As treatment, we performed radical high spermatic cord orchiectomy after diagnosis established on intraoperative frozen sections, and conducted follow-up visits by medical examination, serum alpha-fetoprotein (AFP) detection, chest X-ray, ultrasonography and CT for 3-41 (mean 17) months, every month in the first year, every 3 months in the second year and every 6 months in the third year after surgery., Results: Postoperative pathology confirmed yolk sac tumor in all the cases, with negative incisal margin. The level of serum AFP were decreased to normal in 6 cases within 1 month after surgery, all diagnosed as at stage I, and cured without chemotherapy. The other 1 case, with the serum AFP level of 116 microg/L at 1 month after operation, was diagnosed as at stage II and received PVC chemotherapy, but lost to follow-up at 3 months post-operatively., Conclusion: Yolk sac tumor of the testis with concomitant testicular hydrocele is easily misdiagnosed in children. Ultrasonography is necessitated as routine examination in its diagnosis. Radical high spermatic cord orchiectomy can be performed for patients in stage I, and chemotherapy should follow for those in stage II. Its prognosis is similar to that of other yolk sac tumors. Hitherto, there has been no evidence for a definitive correlation between yolk sac tumor of the testis and hydrocele in children.

Background and Objective: The imaging of presacral tumors in children is characteristic. Computed tomography (CT) and magnetic resonance imaging (MRI) have great values in identifying the position, contents and invasion of pediatric presacral tumors before operation. This study was to investigate the CT and MRI features of pediatric presacral tumors, and evaluate the diagnostic values of CT and MRI., Methods: The CT and MRI data of 24 pediatric presacral tumors were analyzed together with pathologic results., Results: Six cases of pediatric presacral tumors were cystic type, with clear margin and complete capsule, and were composed of multi-capsular spaces; on enhanced scan, the capsular wall showed enhancement, while the cystic contents didn't; all these six cases were confirmed benign by pathology. Five cases were solid type and were enhanced inhomogeneously; all were confirmed malignant by pathology. Thirteen cases were cystic-solid type or with obvious necrosis in solid mass. Of the 13 cases, seven were cystic-solid teratoma (including four benign teratomas and three malignant teratomas confirmed by pathology), containing strip calcification, soft tissue and fat; five were endodermal sinus tumors, showing alveolate enhancement; one was neuroblastoma, with macro-lamellar necrosis, extension to the canalis vertebralis and sacrum invasion. Five tumors, including three teratomas, one rhabdomyosarcoma and one endodermal sinus tumor, had unclear margin. Sacrum invasion was found in one teratoma, one rhabdomyosarcoma, one neuroblastoma and one lymphangioma., Conclusions: The location and extend of pediatric presacral tumors can by clearly pictured on CT and MRI. Most tumors can be correctly diagnosed according to their imaging features.

Background & Objective: At present, pediatric testicular yolk sac tumor is hard to be diagnosed at early stage, and the treatment strategy for this disease after radical inguinal orchiectomy is uncertain. This study was to summarize our experience in diagnosing and treating clinical stage I pediatric testicular yolk sac tumors., Methods: Clinical data of ten patients with clinical stage I pediatric testicular yolk sac tumors treated from July 2001 to June 2007 were analyzed., Results: Testicular masses with low or uneven echoes were detected by B ultrasound in 11 testes of ten patients. The serum level of alpha fetoprotein (AFP) was increased in nine patients. Radical inguinal orchiectomy (RIO) was performed for all patients whereas chemotherapy was not administered preoperatively. Pathology examination was used to confirm the diagnosis of yolk sac tumor. One patient with vascular invasion and another one with bilateral testicular yolk sac tumor received cisplatin-based adjuvant chemotherapy. Retroperitoneal lymph node dissection (RPLND) was not performed in these patients. No recurrence was found in nine patients during follow-up with a mean of 3 years. The patient with bilateral testicular tumor had retroperitoneal and lung metastases at 23 months after adjuvant chemotherapy, and achieved complete remission again after salvage chemotherapy., Conclusions: With the combination of B ultrasound and serum AFP level, we can assess and diagnose stage I pediatric testicular yolk sac tumor. RIO could be used to treat it with good outcomes, while RPLND is not necessary. Chemotherapy is recommended to treat patients with high-risk of relapse.

Objective: To evaluate ultrasonography in the diagnosis and differential diagnosis of testicular tumor., Methods: Ultrasound findings and post-operation pathological results were retrospectively studied in 172 men with testicular mass 1998 to 2005., Results: Of the total number, 50 cases were testicular hematoma, 13 testicular cyst, 26 testicular inflammatory node, 25 testicular tuberculosis and 58 testicular tumor. Among 59 testicular tumor cases, 50 were germ cell tumor (including 41 cases of seminoma and 9 cases of nonseminoma germ cell tumor), 6 were non-germ cell tumor and 3 were secondary tumor. The sonographic features of typical seminoma, teratomas, epidemic cyst, interstitial cell tumor and malignant lymphoma were obvious., Conclusion: Ultrasonography, contributive to the preliminary diagnosis and differential diagnosis of testicular tumor and capable of evidence for further treatment, can be the first choice in medical imaging for the diagnosis of testicular tumors.