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Article
October 1985

Modified Neck Dissection for Metastatic Testicular Carcinoma

Author Affiliations

From the Department of Otolaryngology—Head and Neck Surgery, Riley Hospital, Indianapolis (Drs Zeph, Weisberger, and Lingeman), and the Department of Medicine, Section of Hematology and Oncology, University Hospital, Indianapolis (Drs Einhorn and Williams).

Arch Otolaryngol. 1985;111(10):667-672. doi:10.1001/archotol.1985.00800120061007
Abstract

• Carcinoma of the testicle is a unique clinicopathologic entity in that an optimistic attitude toward cure can be entertained even in the presence of distant metastasis. Chemotherapy, followed by an aggressive surgical resection of residual disease, can result in eradication of this neoplasm. This tumor is capable of being monitored by the use of serum markers, namely, human chorionic gonadotropin and α-fetoprotein. After induction chemotherapy, the transition of elevated serum tumor markers to normal levels suggests that malignant disease has been eliminated or converted to teratoma. Elevated markers indicate persistent or recurrent carcinoma and mandate further chemotherapy. If normalization of tumor markers occurs, any residual mass in the abdomen, chest, or neck should be surgically resected. The otolaryngologist plays a role in the diagnosis and the resection of residual neck disease. Metastatic testicular carcinoma can present as a supraclavicular neck mass and must be considered in the differential diagnosis of a mass in this area. Large residual neck lesions are best removed through the exposure afforded by modified neck dissection.

(Arch Otolaryngol 1985;111:667-672)

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