If cytotrophoblasts are not present, then the diagnosis of choriocarcinoma cannot be made. Pure choriocarcinoma is an extremely rare presentation usually associated with widespread hematogenous prognostic value by themselves. Mature teratoma consists of adult-type differentiated elements such as cartilage, glandular epithelium, nerve tissue, or other differentiated cell types. Immature teratoma generally refers to a tumor with partial somatic differentiation, similar to that seen in a fetus. The management of clinical stage I seminoma has not changed significantly in the last 20 years.
Radiation therapy remains the treatment of choice.
Therefore, radiation therapy plays no role in its initial management. There are few data regarding chemotherapy as initial treatment of clinical stage I disease when the risk of retroperitoneal disease is high.