[A case of complete remission obtained with etoposide cis-platinum combination chemotherapy in advanced testicular cancer].

A 49-year-old male patient was admitted to our hospital complaining of right scrotal mass. Serum tumor markers, HCG, beta-HCG and AFP, were all elevated. After right high inguinal orchiectomy, a pathological report revealed a mixed-type germ cell tumor, which was composed of choriocarcinoma, embryonal carcinoma and seminoma. Because of persistent elevation of these tumor markers, RPLND was performed. There were viable tumor cells in the dissected lymph node specimens. As pulmonary metastases developed after RPLND, the patient was treated with 3 courses of VAB-6 combination chemotherapy (vinblastine, actinomycin-D, cyclophosphamide, bleomycin and cis-platinum). Pulmonary metastases disappeared and tumor markers returned to normal range except for moderate elevation of serum HCG. Two months later, pulmonary metastases developed again with re-elevation of tumor markers. Four courses of EP salvage chemotherapy (etoposide and cisplatinum) were given. After EP chemotherapy, the patient was given etoposide orally for about 7 months. During this period, no abnormality was found except for slight elevation of serum HCG. Five months after discontinuing chemotherapy, serum HCG returned to normal and complete remission was obtained.