title: [Severe Acute Myocardial Infarction during Induction Chemotherapy for Retroperitoneal Germ Cell Tumor : A Case Report].
abstract: A 37-year-old man presented at our hospital. Pathological examination of a right orchiectomy specimen, radiographic examination, and tumor marker profile resulted in a diagnosis of retroperitoneal nonseminomatous germ cell tumor (intermediate risk according to IGCC classification). Laboratory testing revealed mild elevation of low density lipoprotein cholesterol. Induction chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started, but he complained of chest pain on day 10 of the second cycle of BEP. We immediately started cardiac monitoring. One hour later, he suffered cardiac arrest due to ventricular fibrillation. Fortunately, sinus rhythm was restored after defibrillation. A diagnosis of acute myocardial infarction (AMI) with total occlusion at the mid-portion of the left anterior descending coronary artery was established by coronary angiography. After percutaneous transluminal coronary angioplasty was successfully performed, he recovered uneventfully. The induction chemotherapy was re-started 19 days after AMI. To avoid endothelial damage by bleomycin, we elected to treat with etoposide, ifosfamide, and cisplatin (VIP). After two further courses of VIP, the patient underwent resection of retoperitoneal tumor and achieved complete remission. The patient has remained disease-free during 3 years follow up without recurrence of AMI.
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Sakka
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Koji
authors.initials: K
authors.lastname: Kawai
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Ippei
authors.initials: I
authors.lastname: Tsujimoto
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kurobe
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Daishi
authors.initials: D
authors.lastname: Ichioka
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Shuya
authors.initials: S
authors.lastname: Kantori
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Kojima
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Suetomi
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Akira
authors.initials: A
authors.lastname: Jouraku
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Jun
authors.initials: J
authors.lastname: Miyazaki
authors.affiliation: The Department of Cardiology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Hoshi
authors.affiliation: The Department of Urology, Doctoral Program in Clinical Sciences, Graduate School of Comprehensive Human Sciences, University of Tsukuba.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nishiyama
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D060828:Induction Chemotherapy; D008297:Male; D009203:Myocardial Infarction / Q000139:chemically induced / Q000628:therapy*; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy*; D012186:Retroperitoneal Neoplasms / Q000188:drug therapy*; D013736:Testicular Neoplasms / Q000188:drug therapy*
chemical_list: D005047:Etoposide; D002945:Cisplatin