Saving an innocent boy's dignity

A Surgical Case of Testicular Sparing

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Dr. Prashant Jain

Dr. Prashant Jain
Sr. Consultant
Paediatric Surgery
BLK Centre of Neonatal,
Paediatric and Adolescent
Medicine
BLK Super Speciality Hospital

Dr. Prashant Jain
“Considering the benign nature of the disease in a young boy, it was decided to salvage the normal portion of the testis and hence, we planned to excise only the diseased part of the testis. Organ sparing approach was applied to the treatment of gonadal tumours especially in young boys, with the goal of minimising over-treatment of benign lesions, preserving functions and providing durable cure. This also takes care of psychological impact of missing gonad in a young boy.”
BLK

THE CASE

A 12-year-old boy was diagnosed with right scrotal swelling for about 10 days, although painless with no apparent history of associated trauma. His parents had consulted a local healthcare facility where he was diagnosed with cystic lesion of the right testis. On further investigation throughultrasound,hewasadvisedremoval ofthe testis (Orchidectomy).

THE PROCEDURE

On clinical examination at BLK, the child was diagnosed with solidcystic mass over the lower pole of the right testis which was non tender. Ultrasound test suggested an enlarged right testis and a well-defined heterogeneous solid cystic lesion of dimension 3.5 cm by 3 cm involving the mid and lower pole of the testis indicative of neoplastic germ cell tumour. On exploration, the tumour was identified over the mid and lower pole of the testis. The frozen section biopsy was indicative of benign nature of the tumour and so Testicular Sparing surgery was performed preserving one third of the testis. The final biopsy report was suggestive of benign germ cell tumour. In view of these findings the patient was further investigated to rule out the possibility of malignant neoplasm. Normal tumour markers ruled out the possibility of malignancy.

THE RESULT

The boy is now out of danger and on the road to recovery. The biggest relief for us and the boy was that we did not have to remove his testicle.