[Contralateral inguinal metastasis from testicular seminoma]

Area of Science:

• Oncology
• Urology

Background:

• Testicular cancer management often involves surveillance or adjuvant therapies.
• Inguinal surgery, such as hernia repair or vasectomy, can alter lymphatic drainage patterns.

Observation:

• A 42-year-old patient with a history of bilateral open inguinal hernia repair and scrotal vasectomy presented with contralateral inguinal seminoma metastasis.
• Staging computed tomography (CT) showed no evidence of further lymphoma or distant organ metastases.

Findings:

• The patient received adjuvant chemotherapy consisting of 3 cycles of cisplatin, etoposide, and ifosfamide.
• The contralateral inguinal metastasis was attributed primarily to the prior inguinal and scrotal surgery, potentially through altered lymphatic pathways, although an atypical retrograde metastatic route was also considered.

Implications:

• This case highlights the importance of thorough physical examination of inguinal lymph nodes in testicular cancer patients with a history of inguinal or scrotal surgery.
• Understanding surgical impact on lymphatic metastasis is crucial for accurate staging and treatment planning in testicular cancer.
• Consideration of altered metastatic routes due to prior interventions is necessary in clinical practice.