[A case of recurrent metastatic testicular cancer, successfully treated with paclitaxel, ifomide and cisplatin].

A 30-year-old man was diagnosed with testicular cancer, and underwent a radical orchiectomy. Pathological diagnosis was a mixed type nonseminomatous germ cell tumor. We diagnosed him as having stage I testicular cancer and decided to forgo adjuvant therapy. After 8 months of follow-up, he was admitted to our department because of brain, lung, and spleen metastases. Since the serum alpha-fetoprotein (AFP) level was present at a high level at 1,297 ng/ml, he was given combination chemotherapy consisting of 3 cycles of PEB, cisplatin, etoposide and bleomycin and one cycle of PE, cisplatin and etoposide. Because of the decline in lung diffusing capacity, the administration of bleomycin was stopped in the final course. However, the AFP level remained above 14 ng/ml. Then he was given one more cycle of VIP therapy (etoposide, ifosfamide, cisplatin), but the serum AFP level was increased to 56 ng/ml. Then, two cycles of chemotherapy with paclitaxel, ifosfamide and cisplatin were administered as salvage chemotherapy, which led to a normalization of the serum AFP level, and disappearance of the brain and spleen metastases. Residual lung mass was resected at the surgical department, and microscopically no viable tumor cells remained. Three years after his final hospitalization, the patient has had no evidence of recurrence or metastasis.