Treatment options for stage I nonseminoma
Neoplasms, Germ Cell and Embryonal
© 2014 by American Society of Clinical Oncology. Three weeks ago, a healthy 29-year-old man underwent a left orchiectomy for a left testis mass revealing a 3-cm mixed nonseminomatous germ cell tumor composed of embryonal carcinoma and teratoma. Lymphovascular invasion was identified (Fig 1), but there was no invasion into the rete testis or other structures. Preoperative α-fetoprotein was elevated at 42 ng/mL but normalized to 3.5 ng/mL postoperatively. Human chorionic gonadotropin and lactate dehydrogenase were normal both before and after orchiectomy. A computed tomography scan of the chest, abdomen, and pelvis with contrast obtained 1 week ago revealed no evidence of retroperitoneal adenopathy or other sites of metastatic disease. The patient presents to see his physician, eager to discuss his treatment options and make a decision between adjuvant treatment and surveillance.
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