Extensive arterial and venous thrombo-embolism with chemotherapy for testicular cancer: a case report

Abstract

Germ cell tumours tend to affect young adults and with advanced treatments achieve more than 90% cure rates. Over the years cisplatin has significantly improved the relapse free survival in these patients, hence forming an essential component of chemotherapy regimes. But, the thrombo-embolic complications suffered with cisplatin significantly affect the quality of life in these young patients.We describe a young adult who suffered a potentially fatal cerebral and pulmonary vascular insult on completing first cycle of cisplatin-based chemotherapy for a non-seminomatous germ cell tumour. Venous and arterial thrombo-embolism was the mechanism of injury and was promptly managed surgically and medically including neuro-rehabilitation.

Figure 1

Ultrasonograph of Testis showing the seminomatous tumour of left testis.

Figure 2

Admission CT scan of Brain showing no evidence of Ischaemia or Intracranial bleed.

Figure 3

Diagnostic Colour Doppler Ultrasonograph of Left Carotid system showing the thrombus in Left Internal Carotid Artery.

Figure 4

Post-operative CT- Angiogram showing compromised Carotid and Cerebral circulation.

Figure 5

Post-operative Remodeled CT- Angiogram showing compromised Carotid and Cerebral circulation.

Figure 6

Post operative CT scan of brain showing ischaemic changes in Left Middle Cerebral artery territory.