Patterns of metastatic spread in prepubertal yolk sac tumor of the testis.

Of the 212 patients with yolk sac tumors of the testis registered in the prepubertal testis tumor registry of the American Academy of Pediatrics, Section on Urology, we report on 33 who presented with metastatic disease. Metastases occurred to the retroperitoneum alone in 9 cases, sites consistent with hematogenous spread of disease alone in 13, sites consistent with lymphatic and hematogenous spread in 6, and sites not clearly documented in the registry in 5. These findings, which show a hematogenous predilection in the spread of metastases, suggest that retroperitoneal lymph node dissection has no routine role in the treatment of the child who presents with yolk sac tumor of the testis.