Usefulness of positron emission tomography (PET) in a retroperitoneal primary non-seminomatous germ cell tumor: a case report.

A 32-year-old Japanese man was admitted complaining of palindromic fever and abdominal pain. Computed tomography (CT) revealed retroperitoneal mass and positron emission tomography (PET) demonstrated massive radiotracer uptake in this tumor. Serum levels of alpha-fetoprotein (AFP) and human chorionic gonadotropin (hCG) were 4,760 ng/ml, 6,000 mIU/ml, respectively. Biopsy specimen from the tumor showed non-seminomatous germ cell tumor. The International Germ Cell Cancer Collaborative Group (IGCCCG) staging system indicated this case as an intermediate prognosis group. After three cycles of bleomycin, etoposide and cisplatin (BEP) therapy, CT revealed a degenerated residual mass. Serum levels of tumor markers were normalized completely and PET showed no radiotracer uptake in the retroperitoneal lesion. Although he did not receive further chemotherapy and lymph nodes were not dissected, he was free of disease for two years.