A 35 year old male presented with complaints of oliguria, on evaluation he had mass per abdomen, left undescended testes and pedal oedema. Renal profile test –raised blood urea and serum creatinine. CECT abdomen revealed 15x 14 cms large soft tissue density mass in pelvis. Testicular tumor marker study revealed raised beta-HCG with normal AFP and raised LDH Patient was diagnosed with seminomatous germ cell tumor arising from left intra abdominal testis. Haemodialysis was done for 3days and RFT improved slightly. Patient was planned for Platin based chemotherapy. Patient received 3 courses of carboplatin for 3weeks.After chemotherapy, blood urea and serum creatinine came within normal limits and urine output improved and regression of tumor mass was seen. After 1 month of CECT abdomen revealed no mass. Post chemotherapy serum tumor markers were decreased. He is being followed up regularly with serum tumor markers. Discussion: Persistently cryptorchid (inguinal and abdominal) testis are at higher risk for seminoma (74%), while corrected cryptorchid or scrotal testicles that undergo malignant transformation are most likely to become nonseminomatous (63%,p<0.0001), presumably because of a decreased risk of seminoma. Conclusion: Seminoma is associated with increased sensitivity to platin based chemotherapy and radiation therapy.Relative to cisplatin , the greatest benefit of carboplatin is its reduced side effects, particularly the nephrotoxic effects.In our case chemotherapeutic agent carboplatin was found to be effective which not only relieved urinary symptoms but also helped reduction in size of malignancy.Initially chemotherapy followed by 1-stage surgical removal of the primary and residual metastasis is a favourable option to improve compliance.
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