Mixed Germ Cell Tumor of the Testis with Post- Chemotherapy Perineal Tumor Recurrence

We present an 18-year-old man who was treated with four courses of BEP (bleomycin, etoposide and cisplatinum) chemotherapy after left orchiectomy for mixed seminomatous and non- seminomatous germ cell tumor of the testis. He presented four months post-chemotherapy with a left scrotal mass which was excised and histologically diagnosed as granulation tissue. A month later he presented with a perineal and left pararectal mass fungating through the skin, which was treated by excision of the mass. Histopathological examination showed mature teratoma with endodermal components but no malignant elements. At 24 months follow-up the patient was disease-free. It remains speculative whether the scrotal and perineal tumors represent local recurrence or true metastases of post-chemotherapy teratoma.