Rare Neuroblastoma Component Found in Infant’s Testicular Teratoma

Doctors at the Children's Hospital of Hebei in Shijiazhuang, China, have reported an exceptionally rare finding in a boy aged just 4 months and 25 days: a prepubertal-type testicular teratoma containing minute, multifocal components of neuroblastoma, a tumor type that normally arises outside the testis. The case, described in Frontiers in Oncology in the pediatric oncology section, expands the known clinicopathologic spectrum of a tumor group that is usually considered biologically benign. Prepubertal-type testicular teratomas are germ cell tumors seen in infants and young children, and they generally behave in a benign fashion.

They may contain mature or immature neural tissue, which pathologists routinely encounter and recognize. What makes this case unusual is the presence of a peripheral neuroblastoma component, which is extraordinarily rare in this setting and can be difficult to distinguish from the conventional immature neuroepithelium that teratomas commonly contain. The boy underwent testis-sparing excision of a right testicular teratoma, an approach that preserves the organ rather than removing it entirely.

Histopathologic examination of the excised tissue identified the minute, multifocal neuroblastoma components embedded within the prepubertal-type teratoma. The defining diagnostic clue came from immunohistochemistry: the lesional cells showed diffuse, strong nuclear expression of paired-like homeobox 2B, known as PHOX2B, a transcription factor marker that is characteristic of neuroblastoma and helped separate the component from ordinary immature neural elements. Molecular testing added further reassurance.

Fluorescence in situ hybridization, or FISH, showed no MYCN amplification, no telomerase reverse transcriptase (TERT) rearrangement, no 1p36 deletion and no 11q23 deletion. Imaging studies revealed no extratesticular primary tumor and no metastatic disease, an important step in confirming that the neuroblastoma tissue was a component of the testicular teratoma rather than a metastasis from a tumor arising elsewhere in the body. During approximately 14 months of follow-up, no recurrence or metastasis was observed, a measured observation that the authors report without extrapolating beyond the follow-up window.

The authors state that the case expands the clinicopathologic spectrum of prepubertal-type testicular teratoma and provides additional morphologic, immunophenotypic and molecular characterization of this rare presentation in infancy. Because the report describes a single patient, the findings define what was seen in this one case rather than establishing general patterns of behavior for similar tumors, and the authors note that all claims in the article are solely their own and do not necessarily represent those of their affiliated organizations or the publisher. The case was received by the journal on 16 September 2026 and accepted on 12 October 2026, with the final formatted version to be published soon.

Correspondence for the report is attributed to Yonghui Yang and Lingyan Wang of the Hebei Clinical Research Center for Child Health and Diseases, and the work originated from that center together with Hebei Medical University in Shijiazhuang. The article is published open access under the Creative Commons Attribution License.

Subject of Research: A rare infant case of prepubertal-type testicular teratoma containing a neuroblastoma component

Article Title: Prepubertal-type testicular teratoma with a neuroblastoma component in an infant: a case report

Article References: Zhang, L., Mei, J., Zhang, L., Liu, L., Yang, Y., & Wang, L. (2026). Prepubertal-type testicular teratoma with a neuroblastoma component in an infant: a case report. Frontiers in Oncology, 16, Article 2000023. https://doi.org/10.3389/fonc.2026.2000023

Image Credits: AI Generated

DOI: 10.3389/fonc.2026.2000023

Keywords: testicular teratoma, neuroblastoma, infant, PHOX2B, MYCN, FISH, pediatric oncology, prepubertal-type teratoma, case report, testis-sparing surgery, immature neural tissue, Frontiers in Oncology