Successful Response of Extragonadal Retroperitoneal Seminoma to Chemotherapy

Abstract

The majority of germ cell tumours in the male present as a swelling in the testis. Approximately 1 to 2% of germ cell tumours arise in extragonadal locations, with no obvious testicular primary tumour (Collins & Pugh, 1964). Most of the extragonadal tumours arise in either the mediastinum or the retroperitoneum, and rarely in the pineal or the sacro-coccygeal region (Friedman, 1947; Lasco, 1942). Except for the pineal tumours, these tumours often grow to a considerable size before symptoms arise and a diagnosis is made. The extragonadal origin is now accepted, although even with clinically normal testes occult or spontaneously regressed testicular primary tumours may be difficult to exclude (Abell et al, 1965). Before the development of effective chemotherapy for metastatic germ cell tumours, most extragonadal seminomas were treated with radiation, to which they are very sensitive (Abell et al, 1965; Feun et al, 1980; Routh et al, 1982). The success rate with bulky disease is poorer (Einhorn, 1980), but m...