Intratunical injection of methotrexate for the treatment of seminoma of the testicle.

A bilateral testicular seminoma in a 32 year old man is reported. The patient was unmarried and refused bilateral orchidectomy for its sterile result. He was treated with four courses of methotrexate (MXT) injected in the tunica vaginalis sac. Each course comprised the administration of 50 mg MXT in each tunical sac every 5 days for five consecutive doses followed by 3 weeks rest. No toxicity was encountered. Testicular biopsy 6 months after the start of treatment was negative for malignant cells. A temporary drop of sperm count occurred during treatment. Treatment was performed 6 years ago, and the patient has had no recurrence and is fertile. The treatment was done on an outpatient basis.