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Prepubertal testicular tumours are very rare and occur at an incidence of 0.5–2/100 000 children.1,2 Of all the paediatric malignancies they rank seventh in frequency and represent only 1% of all paediatric solid tumours.3
We conducted a study to see the pattern of prepubertal testicular tumours in Kashmir. The material for our study was obtained from the files of the histopathology section of the department of pathology, Government Medical College, Srinagar, Kashmir, India. The records of all prepubertal testicular tumours reported from January 1984 to December 1998 were studied. Routine and special stains were applied on fresh sections from paraffin wax embedded blocks wherever required. Fifteen prepubertal testicular and paratesticular tumours were recorded in the 15 year period of our study. Germ cell tumours predominated: there were 12 germ cell tumours and only three non-germ cell tumours. There were 10 yolk sac tumours, two teratomas (mature), two rhabdomyosarcomas (paratesticular), and one non-Hodgkin’s lymphoma-Burkitt’s lymphoma. The youngest patient was 10 months old and the oldest was 14 years old. Ten patients presented at or below the age of 4 years. The youngest patient (10 months of age) had a yolk sac tumour and the oldest (14 years old) had rhabdomyosarcoma. In two patients both testes were involved, with one of these two patients having bilateral undescended testes. Prepubertal testicular tumours most commonly occur within the first 4 years of life.4 Although the cut off age for our analysis was 14 years, most patients presented at or below the age of 4 years. Most of the germ cell tumours were yolk sac tumours (10 of 12), followed by teratoma (two of 12). Mostofi recorded 15 cases of yolk sac tumour (embryonal cell carcinoma) in a total of 22 cases and seven cases of teratoma.5
Yolk sac tumour is widely accepted today as the most common prepubertal germ cell tumour.1,3 Rhabdomyosarcoma was the second most common tumour recorded in our series. It is the most common mesenchymal malignancy of paratesticular tissue in the prepubertal age group.3 We found one case of Burkitt’s lymphoma in a 5 year old child involving both the testes. Although rare, cases of Burkitt’s lymphoma involving the testis have been reported in the literature.3
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