Primary Chemotherapy in a 47-Year-Old Patient with Giant Ulcerative and Necrotizing Nonseminomatous Testicular Germ Cell Tumor

Testicular cancer is a rare disease; however, cure rates are high for all tumor stages. Mostly, the disease diagnosed in an early (local) stage. We report case of 47-year-old male patient with giant nonseminomatous germ cell tumor. At time diagnosis, demonstrated necrotizing and ulcerating growing mass left scrotum approximate size 22 × 18 cm. According to prognostic classification International Germ Cell Cancer Collaborative Group (IGCCCG 1997), exhibited high-risk profile due alpha-fetoprotein >10,000 ng/mL lactate dehydrogenase >10× upper limit normal serum. Primary orchiectomy was infeasible tumor’s size, patient’s poor general condition initial intensive care unit treatment. systemic chemotherapy applied. After 3 cycles cisplatin, etoposide bleomycin, along 1 cycle ifosfamide, resection histomorphological examination showed complete pathological response. Despite delayed initiation therapy, primary completed timely promising results. Reasons late hospitalization were personal responsibilities regarding his family. Better awareness knowledge testicular among young men might prevent here reported delay medical consultation avoid tumors such enormous size. Psychosocial assessment distress management important as integral part comprehensive patients.