title: A case of metastatic testicular cancer complicated by tumour lysis syndrome and choriocarcinoma syndrome.
abstract: A 26-year-old man was referred to our hospital for treatment of metastatic testicular cancer. The pathological diagnosis was choriocarcinoma with seminoma. Sequential computerized tomography examinations revealed rapidly progressing bulky liver metastases and a lung metastasis. Chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started on the day of admission. Subsequently, the patient suffered from tumour lysis syndrome (TLS) and massive haemorrhage at metastatic sites. The latter complication is also called choriocarcinoma syndrome. To our knowledge, this is the first case report of testicular cancer complicated with both critical conditions. Intensive care and radiological intervention barely prevented a fatal outcome. The urological oncologist should be aware of the potential complications TLS and choriocarcinoma syndrome in cases of rapidly progressive and high-volume choriocarcinoma.
authors.affiliation: Department of Urology, Institute of Clinical Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba-City, Ibaraki, Japan. rkawa@md.tsukuba.ac.jp
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.forename: Ei-Ichiro
authors.initials: E
authors.lastname: Takaoka
authors.forename: Makito
authors.initials: M
authors.lastname: Naoi
authors.forename: Kensaku
authors.initials: K
authors.lastname: Mori
authors.forename: Manabu
authors.initials: M
authors.lastname: Minami
authors.forename: Toru
authors.initials: T
authors.lastname: Shimazui
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Akaza
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001761:Bleomycin / Q000009:adverse effects; D002822:Choriocarcinoma / Q000188:drug therapy* / Q000556:secondary; D002945:Cisplatin / Q000009:adverse effects; D004334:Drug Administration Schedule; D005047:Etoposide / Q000009:adverse effects; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D007069:Ifosfamide; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy / Q000473:pathology; D011860:Radiography, Abdominal; D018239:Seminoma / Q000188:drug therapy* / Q000556:secondary; D043823:Taxoids; D013736:Testicular Neoplasms / Q000188:drug therapy* / Q000473:pathology; D014057:Tomography, X-Ray Computed; D015275:Tumor Lysis Syndrome / Q000209:etiology*
chemical_list: D043823:Taxoids; D001761:Bleomycin; D005047:Etoposide; D002945:Cisplatin; D007069:Ifosfamide