The authors report the clinical case of a 34 years old male, with a germ cell tumor of the testis, who developed large retroperitoneal metastasis, with compression and later on invasion of the inferior vena cava. The patient underwent chemotherapy followed by resection of the original tumor and of the retroperitoneal metastasis and the vena cava was replaced by a vascular prosthesis. The post operative course was uneventful and one year later he was found in excellent condition. The rarity of the situation as well as of its surgical management justifies the presentation and the discussion of the case, based on the most recent data of the literature dedicated to the topic.