Testicular
rhabdomyosarcoma is relatively rare in
testicular tumors, but the age of patient is relatively young and the degree of
malignancy is high. Therefore, this article introduces 4 cases of testicular
rhabdomyosarcoma who were admitted to Peking University Third Hospital from May 1994 to February 2019, and reviews the literature to improve the diagnosis and treatment of this disease. The average age of the 4 patients was 17.5 years (14-21 years), the average
hospital stay was 22.0 d (17-31 d), and the average body mass index was 19.6 kg/m2 (14.7-25.8 kg/m2). All the patients underwent routine preoperative blood and urine routine, biochemical tests, as well as serum
tumor markers. Preoperative examinations also included chest radiograph, electrocardiogram, ultrasound of the scrotum and groin, and abdominal enhanced CT. Lung CT or other examinations were performed if necessary. The median serum
human chorionic gonadotropin (HCG) of the 4 patients was 0.20 IU/L (0.06-0.86 IU/L) (all normal), and the median serum
alpha-fetoprotein (AFP) was 1.03 g/L (0.65-1.66 g/L) (all normal). The average maximum diameter of the
tumor was 10.0 cm (4.5-15.0 cm). Testicular
rhabdomyosarcoma was mainly diagnosed by pathology. The main treatment was radical
orchiectomy combined with retroperitoneal
lymph node dissection, with or without postoperative
adjuvant chemotherapy. The clinical manifestations of the patients with testicular
rhabdomyosarcoma had no specific characteristics, but most patients were young at onset with mainly painless masses in the testicles, which were already large when they were found. Patients with testicular
rhabdomyosarcoma have a poor prognosis, most of whom recur within two years. Because of the small number of cases of testicular
rhabdomyosarcoma, there is no standard treatment currently. It is recommended that patients with testicular
rhabdomyosarcoma undergo radical testicular resection combined with retroperitoneal
lymph node dissection. Retroperitoneal
lymph node metastasis is an important prognostic factor, and patients with postoperative
adjuvant chemotherapy can still survive for a longer time. If local recurrence or limited
metastasis is found after operation, local resection and salvage
radiotherapy are feasible.