Abstract
Background: Germ cell tumors (GCTs) are the most common solid tumors in young men,
with a peak incidence at 25-35 years. Approximately 50% of the testicular GCTs are pure
seminomas and 50% are non-seminomas. Late relapse of testicular cancer (LRTC) is a rare
disease with the incidence rate of 2.6% and is defined as >2 years interval between initial
treatment and recurrence.
Case Presentation: We report here a patient with nonseminomatous GCT who experienced
relapse 27 years after his first diagnosis. He came with gross hematuria and huge
abdominal mass. There was a giant retroperitoneal mass with invasion to the left kidney
and other organs in computerized tomography. A biopsy was conducted and pathology
revealed recurrence of malignant mixed nonseminoma GCT. The tumor was unresetable.
Therefore patient was treated with four cycles of chemotherapy. PET scan was conducted
after chemotherapy showed residue of tumor thus retroperitoneal lymph node dissection
(RPLND) was done.
Conclusions: We concluded that with increasing lifespan of cancer patients, follow up of
these patients for very late relapse must be conducted lifelong.