Inguinal node metastases from testicular tumors in patients with prior orchiopexy

Testicular tumors in patients who have had the lymphatics disrupted by prior scrotal or inguinal surgery can metastasize primarily to the ipsilateral inguinal nodes in addition to the usual retroperitoneal pattern. Whether routine inguinal node dissection along with retroperitoneal node dissection is warranted in patients with testicular tumors and prior scrotal surgery is controversial due to the small numbers of such cases reported in the literature. We report on 2 patients who had undergone previous orchiopexy and who presented with inguinal and testicular masses. Both patients underwent retroperitoneal lymph node dissection and inguinal node dissection with hemiscrotectomy and metastatic tumor was in each lymphatic area. Ipsilateral inguinal along with bilateral retroperitoneal node dissection should be considered in the primary therapy of any patient with a nonseminomatous testicular tumor who has had prior scrotal and certain inguinal procedures.