Clinical and pathologic material from 16 infants with embryonal carcinoma of the testis was reviewed specifically as to the route of metastatic spread and the findings obtained from retroperitoneal lymphadenectomy. Hematogenous metastases were noted in 3 patients (19 per cent) and lymphatic metastases were observed in 2 patients (13 per cent). In 12 patients in whom disease was clinically limited to the testis retroperitoneal lymphadenectomy was negative, although a review of the literature suggests that unsuspected metastases might be expected in 6 per cent of such patients. The 2 patients who had lymph node metastases had large, clinically evident but unresectable retroperitoneal lymph node masses. The low yield of retroperitoneal metastases in early disease makes lymphadenectomy suspect as a primary staging or treatment procedure, but the occasional patient presenting with retroperitoneal disease requires that the procedure not be abandoned at this time.
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