title: Extensive deep vein thrombosis as a complication of testicular cancer treated with the BEP protocol (bleomycin, etoposide and cisplatin): case report.
abstract: BACKGROUND
  There are no reports in the literature of massive deep venous thrombosis (DVT) associated with cisplatin, bleomycin and etoposide (BEP) cancer treatment.
  
  
  METHODS
  The patient was a 18-year-old adolescent with a nonseminomatous germ cell tumor of the right testicle, with the presence of pulmonary, liver, and massive retroperitoneal metastases. Following radical orchiectomy, the patient started chemotherapy according to the BEP protocol (without routine prophylaxis for DVT). On day 4 of the first cycle, massive DVT was diagnosed, extending from both popliteal veins up to the thoracic segment of the inferior vena cava. Thrombolytic therapy with streptokinase was immediately started. On day 2 of thrombolytic therapy, the patient developed acute renal failure, due to extension of the thrombosis to the renal veins. Streptokinase was continued for six days and the outcome was remarkably favorable.
authors.affiliation: Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil. max.mano@gmail.com
authors.forename: Max Senna
authors.initials: MS
authors.lastname: Mano
authors.forename: José Luiz Miranda
authors.initials: JL
authors.lastname: Guimarães
authors.forename: Sören Franz Marian Chicata
authors.initials: SF
authors.lastname: Sutmöller
authors.forename: André Borba
authors.initials: AB
authors.lastname: Reiriz
authors.forename: Christian Sandor Svend Chicata
authors.initials: CS
authors.lastname: Sutmöller
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Leo
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D013300:Streptokinase / Q000627:therapeutic use; D013736:Testicular Neoplasms / Q000188:drug therapy*; D018616:Ultrasonography, Doppler, Duplex; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D005343:Fibrinolytic Agents; D001761:Bleomycin; D005047:Etoposide; D013300:Streptokinase; D002945:Cisplatin