Prolonged survival after cerebral metastasis of testicular carcinoma.

A 30-year-old man underwent orchiectomy in 1962 for a testicular carcinoma composed of choriocarcinomatous and teratocarcinomatous elements. Bilateral pulmonary metastases regressed completely on combination chemotherapy. However, a cerebral metastasis developed in 1963 and caused severe neurologic signs. At craniotomy a large mass of choriocarcinomatous tissue was incompletely removed. Further chemotherapy resulted in a complete remission. The patient remains free of disease more than 16 years later. The treatment of cerebral metastasis is discussed, with emphasis on the possibility of long-term survival and the role of surgery.