Salvage Combination Chemotherapy with Docetaxel, Ifosfamide and Cisplatin (DIP): Successful Treatment of a Case with Metastatic Testicular Immature Teratoma

Abstract

We present a case of metastatic testicular immature teratoma that was successfully treated despite resistance to standard chemotherapy and unsuccessful salvage surgery. At first, BEP (bleomycin, etoposide and cisplatin) treatment was performed but failed. The patient underwent incomplete retroperitoneal lymph node dissection. He was then referred to us. By the time of the referral lung and mediastinal lymph node metastasis had appeared and para-aortic lymph node metastasis had grown larger. We administered the DIP (docetaxel, ifosfamide and cisplatin) regimen as a second line chemotherapy, which was effective with 82% reduction of para-aortic lymph nodes, 88% of mediastinal lymph nodes and 85% of lung metastasis. We performed para-aortic lymph node dissection followed by resection of lung metastasis and mediastinal lymph node dissection. The patient is now followed-up at the outpatient clinic without evidence of recurrent disease 3.5 years after the last surgery.