SPERMATIC CORD CONTAMINATION IN TESTICULAR CANCER

It is not uncommon to find testicular germ-cell tumors in the spermati c cord. This may represent contamination or true involvement (vascular invasion or direct tumoral extension into the cord). A correct identi fication of the process has important clinical implications, In a revi ew of 326 testicular germ-cell tumors, 79 (24.2%) revealed tumor in th e spermatic cord, Of these 79, contamination was found in 57 (72.1%), true involvement in 15 (19%), and true involvement and contamination i n 7 (8.9%). Spermatic cord contamination was seen most frequently with seminomas: 34 (24.1%) of 141 seminomas and 20 (15.4%) of 130 mixed ge rm-cell tumors, Eighteen of the 20 mixed germ-cell tumors contained an embryonal carcinoma component, True involvement was seen most frequen tly in embryonal carcinoma. Six (15.4%) of 39 pure embryonal carcinoma s demonstrated true cord involvement. Six mixed germ-cell tumors with true cord involvement contained an embryonal carcinoma component. Dist inguishing between true involvement of the spermatic cord and contamin ation can occasionally be problematic, Because true involvement, espec ially at the spermatic cord resection margin, identifies patients at a high risk for relapse, the problem of contamination caused by inadequ ate precautionary measures can be avoided by meticulous handling and p rocessing of the specimens.