IVC tumoural thrombosis: an unusual complication of testicular tumour

Description

A 30-year-old man presented with right scrotal mass and bilateral leg oedema for the last 3 months. CT scan showed a heterogeneously enhancing lesion in the right testis with retroperitoneal and mediastinal lymph node (LN) mass with enhancing tumorous thrombus filling the common iliac veins and inferior vena cava (IVC) up to the infrahepatic region with pulmonary metastases (figure 1). The preoperative tumour markers including lactate dehydrogenase, alpha-fetoprotein and human chorionic gonadotropin were 2270 U/L, 28 214 ng/mL and 6253 mIU/mL, respectively. High inguinal orchidectomy was carried out which revealed mixed germ cell tumour (GCT) (pT3N3M1aS3, poor risk as per International Germ Cell Cancer Collaborative Group). Chemotherapy including four cycles of VIP (etoposide, ifosfamide and cisplatin) with anticoagulation was started in the immediate postoperative period. Standard BEP (bleomycin, etoposide and cisplatin) xfour regimen could not be given because of poor pulmonary function. Postchemotherapy CT scan after 4 weeks revealed complete resolution of IVC thrombus with small residual...

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