[Differentiated teratoma as late recurrence of metastatic non-seminomatous testicular germ cell tumor. Case report and clinical problems].

This report describes the rare event of late recurring adult teratoma 76 months after the treatment of a metastasized, nonseminomatous germ cell tumor. Following chemotherapy, residual tumor masses localized in the retroperitoneum as well as in the chest were completely resected. At the recurrence serum tumor markers "alpha-fetoprotein" (AFP) and "human chorionic gonadotropin" were not elevated. Abdominal CT scan revealed a cystic tumor without any solid components in the right obturator fossa. This tumor was excised and the histological examination revealed pure adult teratoma. Late recurrence ( > 24 months after initial therapy) following chemotherapy for the treatment of metastasized testicular germ cell tumors is a rare event (2-4%). Whereas overall prognosis of late recurrence is poor, the clinical course of patients with mere teratomatous differentiation within the recurrent tumor is somewhat better if complete surgical resection is performed. Clinical implication of late recurrence following treatment of metastasized nonseminomatous germ cell tumors are discussed.