Luminita Gurguta Mihai V Marinca


We present the case of a 32-year old male, diagnosed in 2003 (at the age of 22) with stage IIB testicular cancer. After orchiectomy he had received 4 cycles of chemotherapy (BEP protocol). In 2013 the disease relapsed (S2-level tumor markers, multiple lung metastases, compressive and invasive abdomino-pelvic adenopathy). Performance status (PS) at presentation was poor (ECOG PS 2), he reported diffuse abdominal pain (VAS 5) and deep vein thrombosis in the right leg. Salvage chemotherapy (TIP protocol) was administered for 6 cycles, with grade 2-3 hematologic toxicity. Post-treatment evaluation revealed a good partial response: single pulmonary nodule (no FDG uptake), and 4.4-cm intraabdominal mass (SUV 6.0). Non-nerve-sparing salvage right retroperitoneal lymph node dissection was decided, and one microscopic focus of embryonal carcinoma was the only postoperative pathology finding. The patient is currently disease-free.



NSGCT, late relapse, salvage chemotherapy, response evaluation

1. Casciato DA, Territo MC. Manual of Clinical Oncology, 7th Edition. Philadelphia: Lippincott Williams & Wilkins, 2012.
2. Hussain SA, Ma YT, Cullen MH. Management of metastatic germ cell tumors. Expert Rev Anticancer Ther 2008; 8(5):771–784.
3. Albers P. Diagnosis, staging, and risk factors: SIU/ICUD Consensus Meeting on Germ Cell Tumors (GCT), Shanghai 2009. Urology 2011; 78:S427-434.
4. Nakamura T, Miki T. Recent strategy for the management of advanced testicular cancer. Int J Urol 2010; 17(2):148-157.
5. Motzer RJ, Agarwal N, Beard C, et al. Testicular cancer. J Natl Compr Canc Netw 2009; 7(6):672-693.
6. Kollmannsberger C, Honecker F, Bokemeyer C. Pharmacotherapy of relapsed metastatic testicular cancer. Expert Opin Pharmacother 2008; 9(13):2259-2272.
7. Khurana K, Gilligan TD, Stephenson AJ. Management of poor-prognosis testicular germ cell tumors. Indian J Urol 2010; 26(1):108-114.
8. Herdrich K, Weinberger H. Selected schedules in the therapy of malignant tumors, 17th Edition. Deerfield: Baxter International Inc, 2013.
9. Beyer, S. Stenning, A. Gerl, et al. High-dose versus conventional-dose chemotherapy as first salvage therapy in patients with non-seminomatous germ-cell tumours: a matched pair analysis. Ann Oncol 2002; 13:599-605.
10. NCCN Clinical Practice Guidelines in Oncology. Testicular cancer, v2.2015 [ available at 05/13/2015].
11. Oldenburg, Fosså SD, J. Nuver J, et al. Testicular seminoma and non-seminoma: ESMO Clinical Practice Guidelines. Ann Oncol 2013; 24(suppl 6):vi125-vi132.
12. Nastały P, Ruf C, Becker P, et al. Circulating tumor cells in patients with testicular germ cell tumors. Clin Cancer Res 2014; 20(14):3830-3841.
13. Fizazi K, Oldenburg J, Dunant A, et al. Assessing prognosis and optimizing treatment in patients with postchemotherapy viable nonseminomatous germ-cell tumors (NSGCT): results from the sCR2 international study. Ann Oncol 2008; 19(2):259-264.
14. Kondagunta GV, Bacik J, Donadio A, et al. Combination of paclitaxel, ifosfamide, and cisplatin is an effective second-line therapy for patients with relapsed testicular germ cell tumors. J Clin Oncol 2005; 23(27):6449-6555.
15. International Prognostic Factors Study Group, Lorch A, Beyer J, et al. Prognostic factors in patients with metastatic germ cell tumors who experienced treatment failure with cisplatin-based first-line chemotherapy. J Clin Oncol 2010; 28(33):4906-4911.
16. Oldenburg J, Wahlqvist R, Fosså SD. Late relapse of germ cell tumors. World J Urol 2009; 27(4):493-500.
How to Cite
Gurguta, L., & Marinca, M. V. (2015). Late recurrence of an embryonal carcinoma of the testis. Case report. Archive of Clinical Cases, 2(2), Arch Clin Cases 2015; 2(2):53-57.
Case Reports

How to Cite

Gurguta, L., & Marinca, M. V. (2015). Late recurrence of an embryonal carcinoma of the testis. Case report. Archive of Clinical Cases, 2(2), Arch Clin Cases 2015; 2(2):53-57.