Very late relapse and management of clinical stage I seminoma after orchiectomy: A case report

The patient was a 44-year-old man with a history of right radical orchiectomy for clinical stage I seminoma 14 years earlier followed by 6 years of surveillance, who presented with right lower leg edema. A thorough examination showed high testicular cancer-related tumor marker values, and based on computed tomography, a diagnosis of right pelvic lymph node metastasis was made. Salvage chemotherapy, consisting of bleomycin, etoposide, and cisplatin was administered followed by secondline chemotherapy with vinblastine, ifosfamide, and cisplatin. The tumor markers were confirmed to be negative, and the patient underwent retroperitoneal lymph node dissection. One year after surgery, there was no evidence of recurrence. Recurrence of clinical stage I seminoma more than 10 years after the initial diagnosis is rarely experienced. We report this case and review the management of clinical stage I seminoma.