How would you treat a recurrent seminoma after 1st line BEP, now growing during salvage TIP despite initial response?

If this is truly growing seminoma, he is now platinum refractory and the ONLY chemotherapy option that would have a chance for cure would be to go straight to high dose carboplatin + etoposide with peripheral blood stem cell transplant. He also is not curable with radiation therapy.

If his serum hCG...

Relapsed seminoma is a tough target. My first step (as usual) is to review all aspects of the case carefully - specifically, was "seminoma" called by an expert tumor pathologist? Over the years, I have seen several diffuse large cell lymphomas and also several variants of nonseminomatous germ cell t...