Atypical lymphatic dissemination of a testicular tumor from a chriptorquid testicle

OBJECTIVES: Atypical lymphatic spread of germ cell tumors to inguinal lymph nodes has been reported mostly related to prior surgical involvement of the inguinoscrotal region, as in orchiopexy. METHODS: A patient with cryptorchidism and failed orchiopexy in his childhood was diagnosed with a testicular neoplasm. Inguinal orchiectomy was performed. RESULTS: Pathological analysis showed classical seminoma spreading into a subcutaneous adjacent lymph node. Further metastatic disease was not found. Patient was treated with adjuvant chemotherapy. CONCLUSIONS: We emphasize the need for accurate staging and a multidisciplinary approach when dealing with onco-urological patients presenting with atypical disease.