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