A 26-year-old man presented with abdominal pain. CT scan revealed a large retroperitoneal heterogeneously enhancing mass originating from the aorto-caval space. Note the compression and deviation of the IVC and the partial encasement of the aorta. The right testicle was not perfused.
The patient underwent a right radical orchiectomy. The pathology was a mixed germ cell tumor, with 90% immature teratoma, 10% seminoma, with foci of other cell lines. The patient underwent four cycles of chemotherapy (BEP: bleomycin, etoposide and cisplatinum). The alphafetoprotein levels returned to normal, but the abdominal tumor did not decrease in size.
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