title: Upper gastrointestinal bleeding from metastatic testicular cancer.
abstract: We report a 22-year-old man who presented with a 2-week history of intermittent melena and worsening scrotal and leg swelling. His medical history was significant for testicular cancer for which he had undergone orchiectomy, lymphadenectomy, and platinum-based chemotherapy. Esophagogastroduodenoscopy (EGD) performed revealed polypoid mass lesions in the second and third portions of the duodenum. Biopsy revealed mixed germ cell tumor with immature teratoma, the same histology as his testicular cancer. His chemotherapy was changed to an ifosphamide-based regimen and a repeat upper endoscopic examination 5 months later revealed complete resolution of previously noted polypoid duodenal mass lesions. This also demonstrates the effectiveness of ifosphamide as second-line therapy in the setting of resistance to platinum-based therapy.
authors.affiliation: Cancer Prevention Fellowship Program, Office of Preventive Oncology, Biometry Research Group, Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, 6130 Executive Blvd, Rm 3121, Bethesda, MD 20892-7354, USA. laiyemoa@mail.nih.gov
authors.forename: Adeyinka O
authors.initials: AO
authors.lastname: Laiyemo
authors.forename: Momodu
authors.initials: M
authors.lastname: Jack
authors.forename: Fitzroy W
authors.initials: FW
authors.lastname: Dawkins
authors.forename: Duane T
authors.initials: DT
authors.lastname: Smoot
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001706:Biopsy; D004379:Duodenal Neoplasms / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000556:secondary*; D016145:Endoscopy, Digestive System; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D008297:Male; D013736:Testicular Neoplasms / Q000150:complications* / Q000473:pathology* / Q000628:therapy