A case of metastatic spermatocytic seminoma with metastases to homolateral retroperitoneal paraaortic lymph nodes in a 50-year-old man is described. The metastases were detected 18 months after orchiectomy. A retroperitoneal biopsy with cytoreductive lymphadenectomy was performed followed by radiotherapy and consecutively by combination chemotherapy. The patient died 25 months after orchiectomy of complications arising after a second course of chemotherapy. No signs of further tumor spread were observed. Autopsy was not performed. The tissue of the metastases fulfilled the light microscopic criteria for spermatocytic seminoma and ultrastructurally showed intercellular communications with typical intercellular bridges. The absence of placental alkaline phosphatase in tumor cells is also consistent with this diagnosis. The metastases differed from the primary tumor in the presence of focal lymphocytic infiltration and granulomatous reaction. This patient represents the first fully documented case of a metastasizing spermatocytic seminoma.

The authors recommend the following risk-adapted treatment procedures: retroperitoneal lymph node dissection in patients with vascular invasion and a major teratoma component, adjuvant chemotherapy in patients with vascular invasion and a major embryonal carcinoma component, and surveillance policy in patients without vascular invasion.

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In patients with advanced germ cell testicular cancer preference must be given to the early beginning of intensive chemotherapy without the need of tissue diagnosis of primary tumor that should be obtained by orchiectomy. Benefit of this therapeutic approach is the timely management of acute abdominal and/or pulmonary symptoms of life-threatening distant metastases.

Over the last twenty years or so, researchers’ attention to the issue of food deserts has increased in the geographical literature. Accessibility to large-scale retail units is one of the essential and frequently-used indicators leading to the identification and mapping of food deserts. Numerous accessibility measures of various types are available for this purpose. Euclidean distance and street network distance rank among the most frequently-used approaches, although they may lead to slightly different results. The aim of this paper is to compare various approaches to the accessibility to food stores and to assess the differences in the results gained by these methods. Accessibility was measured for residential block centroids, with applications of various accessibility measures in a GIS environment. The results suggest a strong correspondence between Euclidean distance and a little more accurate street network distance approach, applied in the case of the urban environment of Bratislava-Petržalka, Slovakia.