Extensive deep vein thrombosis as a complication of testicular cancer treated with the BEP protocol (bleomycin, etoposide and cisplatin): case report.
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.
Mano
Max Senna
MS
Hospital Nossa Senhora da Conceição, Porto Alegre, Rio Grande do Sul, Brazil. max.mano@gmail.com
Guimarães
José Luiz Miranda
JL
Sutmöller
Sören Franz Marian Chicata
SF
Reiriz
André Borba
AB
Sutmöller
Christian Sandor Svend Chicata
CS
Di Leo
Angelo
A
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
D000970:Antineoplastic Agents; D005343:Fibrinolytic Agents; D001761:Bleomycin; D005047:Etoposide; D013300:Streptokinase; D002945:Cisplatin