A 31-year-old man came to our hospital with
chest pain and was diagnosed to have a left
testicular tumor with
metastasis to the lung, and cervical, mediastinal, and retroperitoneal lymph nodes. Left
orchiectomy was performed, and histological diagnosis was
seminoma. Serum
tumor markers were normalized after 3rd-line
chemotherapy, but
lymph node metastases were still enlarged. Then the cervical lymph node was excised, and histologically diagnosed as mature
teratoma. Based on these results, we diagnosed this case as growing
teratoma syndrome. Since the whole
metastasis was too large to be completely excised, we started systemic
interferon alfa-2b (IntronR A) administration. The
metastasis initially responded to the
therapy by 20% reduction in size and remained stable thereafter. However, the mediastinal lesion caused obstructive
pneumonia, which was bronchoscopically resected. At the time of 12 years after the initial presentation, the
tumors are well controlled with stable disease or only modest increase.