Recurrence of seminoma 48 years after orchiectomy: Longest late recurrence and treatment

Although not frequent, the recurrence of seminoma later than 5-10 years after orchiectomy has been reported. We report a case of recurrence of seminoma 48 years after orchiectomy, with metastasis to the para-aorta that was treated with chemotherapy.

An 83-year-old man had an incidentally enlarged para-aortic lymph node noted on computed tomography. Needle biopsy revealed metastasis from a seminoma that had been treated with orchiectomy at age 35. Chemotherapy was introduced but discontinued after the first course due to side effects. However, a decrease in fluorodeoxyglucose accumulation on positron emission tomography was observed, with no subsequent re-enlargement of the tumor.

Chemotherapy was introduced for an elderly patient with the longest known late relapse. Dose reduction should be considered in cases with good prognosis, considering factors such as age.