title: Primary adenocarcinoma of the epididymis: the therapeutic role of retroperitoneal lymphadenectomy.
abstract: OBJECTIVE
  This case report describes a rare case of adenocarcinoma of the epididymis and the role of locoregional surgery in the therapeutic algorithm.
  
  
  METHODS
  We report a case of primary adenocarcinoma of the epididymis in a 61-year-old man who was primarily examined for nodular enlargement of the head of the epididymis. Retroperitoneal lymphadenectomy which the patient underwent after radical orchiectomy revealed lymph node metastases, subsequently he received adjuvant chemotherapy. The patient remains free of disease for 20 months after surgery.
  
  
  CONCLUSIONS
  Primary adenocarcinoma of epididymis is a rare finding with an unfavorable prognosis in higher stages as it responds poorly to radiotherapy and chemotherapy. Our case report confirms the importance of retroperitoneal lymphadenectomy in patients with local or locoregional disease. It may be curative even in case of proven lymphadenopathy and should be performed in all patients without distant metastases.
authors.affiliation: Department of Urology, Masaryk Memorial Cancer Institute, Žlutý Kopec 7, 65653 Brno, Czech Republic. stanik@mou.cz
authors.forename: Michal
authors.initials: M
authors.lastname: Staník
authors.forename: Jan
authors.initials: J
authors.lastname: Doležel
authors.forename: Daniel
authors.initials: D
authors.lastname: Macík
authors.forename: Antonín
authors.initials: A
authors.lastname: Krpenský
authors.forename: Radek
authors.initials: R
authors.lastname: Lakomý
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000556:secondary / Q000601:surgery*; D001706:Biopsy; D003937:Diagnosis, Differential; D004822:Epididymis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods*; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009919:Orchiectomy / Q000379:methods*; D049268:Positron-Emission Tomography; D012187:Retroperitoneal Space; D013736:Testicular Neoplasms / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed