This case takes viewers through the twists and turns of modern germ cell tumor management, starting with a borderline retroperitoneal recurrence after orchiectomy and escalating to complex, high-risk metastatic disease. Dr. Nabil Adra, Dr. Aditya Bagrodia, and Dr. Richard Matulewics highlight real-world decision-making around when to observe, when to operate, and when to initiate chemotherapy, including the challenges of interpreting tumor markers in poor-risk patients. The team illustrates how multidisciplinary care, careful timing, and thoughtful sequencing of therapies can ultimately lead to durable remission even in very advanced disease. It’s a compelling look at how expert centers navigate uncertainty in some of the most challenging germ cell tumor scenarios.
Contributors:
Dr. Nabil Adra is a hematologist and Associate Professor of Clinical Medicine and Urology at Indiana University Health in Indianapolis, Indiana.
Dr. Aditya Bagrodia is an associate professor of urology and genitourinary oncology team leader at UC San Diego Health in California and adjunct professor of urology at UT Southwestern.
Dr. Richard Matulewicz is a urologic oncologist and surgeon at Memorial Sloan Kettering Cancer Center in New York City.
