Salvage combination chemotherapy with docetaxel, ifosfamide and cisplatin (DIP): successful treatment of a case with metastatic testicular immature teratoma

We present a case of metastatic testicular immature teratomathat was successfully treated despite resistance to standardchemotherapy and unsuccessful salvage surgery. At first, BEP(bleomycin, etoposide and cisplatin) treatment was performedbut failed. The patient underwent incomplete retroperitoneallymph node dissection. He was then referred to us. By the timeof the referral lung and mediastinal lymph node metastasis hadappeared and para-aortic lymph node metastasis had grown larger.We administered the DIP (docetaxel, ifosfamide and cisplatin)regimen as a second line chemotherapy, which was effective with82% reduction of para-aortic lymph nodes, 88% of mediastinallymph nodes and 85% of lung metastasis. We performed para-aorticlymph node dissection followed by resection of lung metastasisand mediastinal lymph node dissection. The patient is now followed-upat the outpatient clinic without evidence of recurrent disease3.5 years after the last surgery.