How do you treat primary retroperitoneal choriocarcinoma with liver and lung metastases and markedly elevated B-HCG?

A primary retroperitoneal choriocarcinoma may or may not actually be an occult testis primary, despite the testis being a relative sanctuary site, with normal exam and ultrasound, and no indication for orchiectomy. He has poor risk of disease and needs 4 courses of triple drug therapy, usually with ...

Primary retroperitoneal choriocarcinoma is uncommon. The patient is IGCCC poor risk by several criteria. I strongly favor such patients be managed in high volume centers. There are a number of nuances that make this significantly more complex than good/intermediate disease before, during and after c...

I fully agree with @Dr. First Last's response. In patients with choriocarcinoma and markedly elevated HCG, there may also be a risk of CNS disease, as well as a risk of "choriocarcinoma syndrome" (rare but important), and thus should be managed very closely especially in the first cycle.