Cervical metastases of testicular cancer: presentation of two cases

Abstract Background Testicular cancer metastasis to the cervical region, although rare, is more commonly observed in advanced stages of the disease. These metastases can be managed with various treatment methods. Neck dissection can be safely performed in cases of cervical and mediastinal disease, and successful regional control rates support its use. Furthermore, during long-term follow-up of cured patients, a comprehensive head and neck examination is necessary to ensure that late-stage cervical and mediastinal metastases are not overlooked. In this context, the examination by an otolaryngologist plays a critical role in the patient’s follow-up care. Case presentation Two patients met the specified criteria. Both patients developed recurrence after orchiectomy and received chemotherapy according to the BEP (bleomycin, etoposide, cisplatin) and TIP (paclitaxel, ifosfamide, cisplatin) protocols, respectively. During follow-up after chemotherapy, both patients developed multiple retroperitoneal and extra-retroperitoneal metastases. Various treatment methods, such as re-chemotherapy, retroperitoneal lymph node dissection, and autologous bone marrow transplantation, were applied to these patients. Subsequently, both patients were followed up disease-free for 6 months and 2 years, respectively. Approximately, 2 years later, both patients presented with rapidly developing masses in the neck. PET-CT (positron emission tomography-computed tomograph) imaging suggested a recurrence in the neck, and one patient underwent left posterolateral neck dissection, while the other underwent left 5a-5b-6 cervical dissection. No recurrence or metastasis was observed during the postoperative follow-up of both patients. Conclusion Cervical lymph node metastases originating from testicular cancer are rare but are more commonly observed in patients with advanced-stage disease. Post-chemotherapy residual neck masses can be effectively managed with neck dissection, with the extent of dissection tailored to the location of the mass. Neck dissection can be safely performed both after chemotherapy and in cases of recurrent disease, supported by successful regional control rates.