Introduction

The management of patients with residual masses following chemotherapy for advanced seminoma remains a difficult problem with no clear guidelines. While most patients with advanced seminoma achieve a complete or partial response with cisplatin based chemotherapy1, a significant number will reveal a residual mass on follow up CT scan or MR imaging2,3. Management options for post chemotherapy residual mass in a case of seminoma include close observation, radiation therapy and excisional surgery. While 80 to 85% of residual masses represent either fibrosis or necrotic tissue needing no further therapy, 10 to 15% may contain viable tumor which, if not recognized and effectively treated, may be lethal. A case of a stage II seminoma with post chemotherapy residual mass is presented and contemporary literature on this topic is reviewed.