What is your approach to unresectable metastatic rhabdomyosarcoma transformed from an embryonal cell germ cell tumor?  

More information would be helpful. I infer this is a patient who underwent an orchiectomy for a more typical histology of germ cell cancer, probably with elements of teratoma. He may or may not have had elevated hCG or AFP. He may or may not have received BEP or similar chemotherapy. Perhaps he had ...