Germ Cell Tumors   

Do you routinely check tumor markers between cycles when managing NSGCT? 

Would surgical margins, evidence of angiolymphatic spread, number of lymph nodes removed during surgery inform your decision? 

HCG 850, AFP normal, LDH ~500 pre-orchiectomy.  If tumor thrombus, would you favor 4c of BEP? Would you try biopsy it? How common is IVC thrombu...

If standard of care BEP chemo, tandem transplant, and radiation to primary site have been done previously.

The new mass was noted on imaging after primary tumor resection and 3 cycles of BEP chemotherapy.