Shrinking Hepatic Hemangiomas in a Patient Treated for Metastatic Germ Cell Tumor.

Metastatic germ cell tumors are treated with combination cisplatin chemotherapy, and decisions regarding the optimal number of cycles to deliver are determined by pathologic findings, site of origin, volume of disease, and degree of marker elevation using the International Germ Cell Cancer Collaborative Group Prognostic Risk Classification (IGCCCG). Patients with nonseminoma GCT with liver metastasis are considered poor risk according to the IGCCCG classification and treated with 4 cycles of platinum-based combination chemotherapy In the present case report, we describe a patient with a good-risk primary retroperitoneal GCT and liver lesions consistent with hemangiomas. Our patient received 3 cycles of bleomycin, etoposide, and cisplatin and had a chemoresponsive hepatic hemangioma that mimicked a liver metastasis. The primary tumor and liver lesions both shrank with systemic therapy, potentially from the effect of bleomycin. Chemoresponsive hepatic hemangiomas can mimic the response of liver metastases to therapy, making the ability to distinguish between the 2 difficult.