Fig. 8.48. US of same patient as Fig. 8.47. Note the cystic spaces and focal areas of calcification consistent with teratoma. The patient underwent partial orchidectomy and remains recurrence-free cell malignancy should be treated by radical orchidec-tomy. CT scan should be performed preoperatively in order to avoid potentially false-positive retroperitoneal adenopathy secondary to surgery. However, patients with normal AFP and B-HCG levels can initially undergo resection of the tumor and frozen-section pathological analysis. If teratoma is identified, reconstruction of the remaining testicle is undertaken and orchiopexy performed, as it has been clearly demonstrated that prepubertal pediatric teratoma is a uniformly benign disease process(Shukla et al. 2004). However, if malignancy is identified, the remaining testicular tissue is re sected and high ligation of the spermatic cord carried out. Follow-up studies have demonstrated good long-term outcomes utilizing this approach (Shukla et al. 2004; Gupta et al. 1999; Ciftci et al. 2001).
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