cord: a diagnostic dilemma
2010
Preoperative diagnosis isnotcommonandusuallytheypresentasoperativeor histological surprises. The recommended treat-ment is surgery in the form of wide local excisionwhich in most cases is in the form of radical highorchiectomyfromasclosetothedeepringasposs-ible. There isno indication for routine lymphnodedissections as the loco-regional lymph nodes arerarely involved. The outcome is fairly good inmost cases if the resection is R0 (microscopicfreedom from cancer). Adjuvant radiotherapy isusually not required except in cases with positivemargins or local recurrence and poor prognosticfactors. There is no definite role of chemotherapyand most of the recommendations are based oncases with recurrences. These cancers are,however, known for local recurrences and long-term follow-up of up to 10 years is mandatory;even recurrences after 20 years have beenreported.
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