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Case Report
Salvage chemotherapy with 5-fluorouracil and actinomycin D for advanced testicular germ cell tumor: A case with elevated human chorionic gonadotropin
1 Department of Urology, Niigata Prefectural Central Hospital, 205 Shinnancho, Joetsu City, Niigata Prefecture 943-0192, Japan
Address correspondence to:
Tatsuro Sanami
MD, 205 Shinnancho, Joetsu City, Niigata Prefecture 943-0192,
Japan
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Article ID: 101490Z01TS2025
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Sanami T, Katagiri A, Arinami K, Watanabe K, Inui K, Yamaguchi S. Salvage chemotherapy with 5-fluorouracil and actinomycin D for advanced testicular germ cell tumor: A case with elevated human chorionic gonadotropin. Int J Case Rep Images 2025;16(1):11–15.ABSTRACT
Introduction: Platinum-based chemotherapy is the standard treatment for advanced testicular germ cell tumors. However, selecting third-line and further regimens is difficult in refractory cases. We report a case of testicular mixed germ cell tumor treated with a salvage regimen for high-risk gestational trophoblastic tumor.
Case Report: A 48-year-old male was diagnosed with an advanced mixed germ cell tumor of the right testis with markedly elevated human chorionic gonadotropin levels. Induction and second-line chemotherapy with platinum-based regimens did not achieve normalization of the tumor marker. As salvage chemotherapy, a regimen of 5-fluorouracil and actinomycin D was applied, which led to remission of the tumor marker. However, additional consolidation courses were discontinued due to cumulative adverse events and the patient’s wishes. Ultimately the patient died of tumor recurrence.
Conclusion: We report the first case of testicular germ cell tumor in which a regimen of 5-fluorouracil and actinomycin D showed effectiveness. This regimen for high-risk gestational trophoblastic tumor is also considered a promising treatment option for testicular germ cell tumors with a choriocarcinoma element.
Keywords: Choriocarcinoma, FA, Human chorionic gonadotropin, Testicular tumor
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Author Contributions
Tatsuro Sanami - Conception of the work, Design of the work, Acquisition of data, Analysis of data, Drafting the work, Revising the work critically for important intellectual content, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Akiyoshi Katagiri - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Kentaro Arinami - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Kazuhiro Watanabe - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Kohei Inui - Acquisition of data, Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Shunsuke Yamaguchi - Drafting the work, Final approval of the version to be published, Agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.
Guarantor of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2025 Tatsuro Sanami et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
