[GROWING TERATOMA SYNDROME WITH PERSISTENT HUMAN CHORIONIC GONADOTROPIN ABNORMALITY THAT WAS IN REMISSION...

Area of Science:

• Oncology
• Urology

Background:

• A 30-year-old male presented with a testicular tumor.
• Metastatic disease (stage III B, mixed germ cell tumor) was diagnosed via CT scan, involving para-aortic, mediastinal lymph nodes, and lungs.

Purpose of the Study:

• To investigate the management of a refractory mixed germ cell testicular tumor.
• To explore the cause of persistent Human Chorionic Gonadotropin (HCG) positivity during and after chemotherapy.

Main Methods:

• Initial treatment included bleomycin, etoposide, and cisplatin (BEP) protocol following inferior vena cava filter placement for venous thrombus.
• Subsequent chemotherapy regimens included vinblastine sulfate, ifosfamide, and cisplatin (VIP), and paclitaxel, ifosfamide, and cisplatin (TIP).
• Surgical intervention involved biphasic retroperitoneal and mediastinal lymph node dissections for residual metastatic disease.

Main Results:

• Tumor markers initially decreased, but Human Chorionic Gonadotropin (HCG) remained persistently positive throughout chemotherapy.
• Despite residual disease and ongoing HCG positivity, lymph node dissections stabilized the patient's condition.
• HCG staining was negative in resected tissues, indicating the elevation was not due to residual tumor.

Conclusions:

• Persistent HCG elevation in this non-seminoma testicular cancer case may be linked to abnormal feedback mechanisms induced by chemotherapy.
• Surgical resection of metastatic lymph nodes can stabilize patients even with persistent tumor markers.
• Further research is needed to understand chemotherapy-induced HCG alterations in testicular cancer.