Primary paratesticular neuroblastoma: practical considerations.

Primary neuroblastoma in the paratesticular region is exceedingly rare with only 4 cases reported in the medical literature. The authors report 2 additional cases of primary paratesticular neuroblastoma, both in 6-month old boys who were asymptomatic at presentation. Both cases were stage I diseases, as they typically are in this early pediatric age group. There was no evidence of disease progress or recurrence at 2-year and 10-year follow-up for these 2 patients. The authors also noticed that erroneous assumptions or diagnoses may lead to unnecessary overtreatment, including orchiectomy. In the meantime, frozen section is highly recommended, and a presumptive diagnosis of neuroblastoma from frozen section is usually possible, especially when incorporated with other clinical and lab parameters, and should be attempted. The prognosis typically is favorable. In conclusion, it is becoming clear that primary neuroblastoma is an important differential diagnostic consideration for a paratesticular mass, particularly in the early pediatric age group.