Although a rare presentation for testicular germ cell tumors, the optimal management for stage II disease generates considerable debate, which is, in large part, because of the potential curative role of single-modality treatment in many patients and overall excellent survival in those who require salvage treatment. Individualizing the treatment of each patient to ensure cure with minimal toxicity is challenging, given the rudimentary tools available for predicting disease relapse after initial therapy. Long-term toxicity and patient choice should be taken into account when selecting the management options.
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