[GROWING TERATOMA SYNDROME WITH PERSISTENT HUMAN CHORIONIC GONADOTROPIN ABNORMALITY THAT WAS IN REMISSION POSTOPERATIVELY: A CASE REPORT].

A 30-year-old man underwent a right high orchiectomy for a testicular tumor. A computed tomography (CT) scan revealed para-aortic and mediastinal lymph node and lung metastases, consequently he was diagnosed with pTxN3M1aS2 stage III B, mixed germ cell tumor (teratoma, fibrosis). The bleomycin, etoposide, and cisplatin protocol was initiated after the placement of an inferior vena cava filter for common iliac venous thrombus. Human chorionic gonadotropin (HCG) positivity was observed at the end of the fourth course despite the immediate decrease in tumor markers after the treatment's initiation. The HCG levels remained low and positive after three vinblastine sulfate, ifosfamide, and cisplatin protocol and two paclitaxel, ifosfamide, and cisplatin protocol courses. A subsequent CT scan revealed a developing lymph node metastasis; hence, retroperitoneal and mediastinal lymph node dissections were performed biphasically.Residual tumor resection is indicated for patients with non-seminoma having localized retroperitoneal lesions or resectable lesions and high alpha-fetoprotein. However, the lymph node dissection, performed here, stabilized the patient's condition in a non-HCG-negative and HCG stain-negative state, suggesting that elevated HCG may be attributed to abnormal feedback from chemotherapy.