How do you treat locally advanced choriocarcinoma of the urinary bladder?

This is a very rare site and a rare subset of germ cell tumor. I assume the pathology has been reviewed and full scans including ultrasound of testes if a male and HCG/AFP have been performed. Is the patient in the typical age range for germ cell tumors? If this is confirmed and the patient has a typical MIBC like picture with regional nodal enlargement, I would take a systemic approach with either BEP X 4 or VIP X4 and see where they end up. I do not think it likely that a post-chemo radical cy...