[A case report of extragonadal germ cell tumor with retroperitoneal origin]

A case of extragonadal germ cell tumor is reported. A 41-year-old man, an elementary school teacher, was referred to our department with left abdominal pain and gynecomastia on September, 1985. Laboratory examinations revealed markedly high levels of LDH, AFP and HCG-beta. IVP and abdominal CT disclosed dislocation of the left kidney and the large left retroperitoneal mass. The mass was supplied by the left lumbal arteries on the aortogram. Chest X-ray film showed multiple coin lesions in the bilateral lung fields. By percutaneous needle biopsy, the histological finding of the tumor showed choriocarcinoma. No abnormal findings were found in either testicle by the physical and ultrasonic examinations. This case was diagnosed as extragonadal choriocarcinoma with lung metastasis. After 3 courses of chemotherapy (PVB regimen), resection of the retroperitoneal residual mass and lymphadenectomy were performed. Postoperatively, the chemotherapy, CISCA II - VB IV regimen, was repeated. The patient was discharged after 7 months hospitalization. Now, 35 months after operation, tumor markers, chest X-ray and abdominal CT showed no evidence of recurrence of the tumor.