title: Single inguinal node metastasis of stage I testicular seminoma shown by scrotal scintigraphy, 6 months following radical orchiectomy.
abstract: Lymphatic drainage of the testes is known to follow a predictable pathway that usually involves the retroperitoneal, paraaortic, paracaval and interaortocaval nodal chains. Herein we report the case of a 41 years old man with a stage I testicular seminoma, with an unexpected inguinal lymph node metastasis. During his routine follow-up visit, 6 months after radical orchiectomy, a spherical mass in the right inguinal region was palpated. Thoraco-abdominal CT did not reveal any evidence of retroperitoneal enlarged lymph nodes or distant metastases, but showed a 2cm right inguinal mass. Scrotal scintigraphy with technetium-99m pertechnetate was performed in order to evaluate the local vascularity of the right inguinal area. The angiographic phase (0-1min) and the blood pool images at 15, 30, 45 and 60min revealed high uptake in the right inguinal region, suggesting a hyperemic mass suspicious for tumor recurrence. The excised mass was found to be an enlarged lymph node infiltrated with seminoma. The patient received adjuvant radiotherapy to which he showed a complete response and has been disease free at 2 years follow-up. In conclusion, in the case presented scrotal scintigraphy showed a hyperemic mass at the right inguinal region that proved to be the sentinel node of a stage I testicular seminoma and was treated accordingly.
authors: Department of Urology, University Hospital of Alexandroupolis, Dragana, Alexandroupolis, Greece. bantis68@otenet.gr
authors: Athanasios
authors: A
authors: Bantis
authors: Petros
authors: P
authors: Sountoulides
authors: Christos
authors: C
authors: Kalaitzis
authors: Boussios
authors: B
authors: Nikolaos
authors: Stilianos
authors: S
authors: Giannakopoulos
authors: Athanasios
authors: A
authors: Zissimopoulos
mesh_terms: D000328:Adult; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D009367:Neoplasm Staging; D009919:Orchiectomy; D011877:Radionuclide Imaging; D012611:Scrotum / Q000000981:diagnostic imaging*; D018239:Seminoma / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery; D013736:Testicular Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology* / Q000601:surgery