The relation between testicular tumours, undescended testes, and inguinal hernias

A group of 230 patients with a malignant testicular tumour was found to include 12 patients with a history of an undescended testis (5.2%). Eight patients had a history of inguinal hernia (3.4%). The risk of malignant degeneration in an undescended testis proved to be 17 times greater than in the normal population. We found no increased risk for patients with a history of inguinal hernia. Nine patients with a history of orchiopexy developed a malignant testicular tumour; inguinal lymph node metastases were found in three of them. We advise the removal of all undescended testicles after puberty. In cases of malignant degeneration of a testis, which have been fixed in the scrotum, or in cases with a history of an operation in the inguinal region, the inguinal lymph nodes have to be treated. For seminoma, irradiation of these nodes is necessary; for non-seminoma tumours, hemiscrotectomy and inguinal lymph node dissection have to be performed.