Late recurrence of a seminoma.

We report a case of an extragonadal mediastinal seminoma that recurred almost 19 years after successful initial remission had been achieved with actinomycin D and chlorambucil. Treatment of the recurrence consisted of excision of a single involved supraclavicular lymph node followed by combination chemotherapy with cis-platinum, vinblastine and bleomycin. The patient has remained free of residual disease for 3 years. To our knowledge this case represents the longest reported interval to recurrence for a germ cell neoplasm.