The response of metastatic retroperitoneal seminoma to chemotherapy.

Two patients with advanced metastatic seminoma were treated with radiation therapy, triple-drug chemotherapy and radical surgical resection. In 1 patient the seminoma was radiation-recurrent and radiation-resistant, while in the second patient the metastatic seminoma encroached upon both kidneys and could not be irradiated initially for fear of bilateral radiation nephritis. Both tumors were reduced in size markedly by the chemotherapy and the residual mass was excised in each instance. One patient was free of the tumor 18 months after treatment, while the other patient had recurrence in a distant area after 16 months. The marked responsiveness of both tumors to triple-drug chemotherapy emphasizes the importance of an aggressive approach to advanced metastatic seminoma, including radiation therapy, chemotherapy and surgery.