Metastasis of testicular carcinoma in the inguinal region

A standard protocol for the management of inguinal metastasis from testicular cancer still has not yet been established. Metastasis of testicular cancer to inguinal lymph node rarely occurs, particularly in patients without any prior surgery in inguinal and scrotal region. Daugaard reported 2% incidence of inguinal metastasis for stage 1 testicular cancer in 5-year period. We reported a case of inguinal metastasis from residual testicular cancer with a large size of mass. The case had also been counted as advanced stage since it had further metastasis to the lungs. For this case, surgical treatment of residual tumor excision had been performed prior to the chemotherapy considering a quite large size of tumor mass, which may easily bleed and causing anemia to the patient. Furthermore, we considered that chemotherapy treatment prior to surgical excision will only provide partial effect on the tumor. After the surgery, a 4-cycle combined chemotherapy was administered despite the delay of chemotherapy treatment resulting in residual mass in inguinal region. In fact, the post-surgical chemotherapy treatment in this case has demonstrated relatively good response.