Surgically preventable site of local recurrence of testicular carcinoma

We report on a patient with a mixed germ cell testicular carcinoma in whom recurrence developed at the site of retained spermatic cord elements subsequent to retroperitoneal lymph node dissection. This site for recurrence can be prevented by total removal of the spermatic cord. Recurrence at this site often involves the peritoneum thus significantly reducing the survival rate. It is our policy to attach a long length of nonabsorbable suture marker material to the most proximal aspect of the spermatic cord when performing a radical inguinal orchiectomy. Such a marker facilitates the removal of the entire remaining cord if a retroperitoneal node dissection is performed.