Testicular germ cell tumor with cervical, pulmonary, mediastinal, and retroperitoneal involvement operated on in complete response: case report

Introduction: Testicular germ cell tumors are the most common histological type, representing the second most frequent type of cancer after leukemia in adolescents. They are the most curable solid tumor, even when presenting at advanced clinical stages. Management includes orchiectomy, platinum-based chemotherapy and, in the case of non-seminoma germ cell tumors, if a residual mass ≥ 1 cm remains, resection of the mass should be performed, since teratomas, which carry a risk of malignant transformation, may be found in 50% of the residual mass. Case report: 19-year-old male with a primary mixed germ cell tumor of the right testicle operated, with left cervical, mediastinal and retroperitoneal progression IGCCG2 of intermediate risk, who after four courses of BEP had retroperitoneal lymphadenectomy, left supraclavicular resection and two thoracotomies with mediastinal resection compatible with mature teratoma, remaining to date free of disease after 5 years. Conclusions: Germ cell tumors in advanced clinical stages require multidisciplinary management to provide the best treatment options and thus achieve better survival.