Clinical case of treatment of a patient with germ cell tumor in the intensive care unit

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Abstract

Testicular germ cell tumors are the most common malignant neoplasms in young men. Despite overall high curability, some patients present with advanced disease and critical general condition caused by extensive tumor burden. We report a clinical case of a 28-year-old male with bilateral testicular germ cell tumor (embryonal carcinoma) complicated by metastatic involvement of the lungs, liver, lymph nodes, and inferior vena cava thrombosis extending into the right atrium. The patient was admitted to the intensive care unit due to severe respiratory failure and required mechanical ventilation. Cisplatin monotherapy was initiated, followed by escalation to the paclitaxel–ifosfamide–cisplatin (TIP) regimen with granulocyte-macrophage colony-stimulating factors prophylaxis. Despite the initial critical condition, significant clinical improvement was achieved, including normalization of tumor markers and near-complete response according to CT imaging after four cycles of chemotherapy. This case highlights that systemic chemotherapy can and should be administered even in intensive care settings, including mechanical ventilation, and may lead to clinical recovery and tumor regression.

About the authors

S. A. Arkova

Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: golubev194@gmail.com
ORCID iD: 0000-0002-1843-8743
Russian Federation, Build. 2, 8 Trubetskaya St., Moscow 119048

Pavel V. Golubev

A.F. Tsyb Medical Radiological Research Center – branch of the National Medical Research Radiological Center, Ministry of Health of Russia

Author for correspondence.
Email: golubev194@gmail.com
ORCID iD: 0000-0003-3532-6476
Russian Federation, 4 Koroleva St., Obninsk 249031

E. S. Kuzmina

S.S. Yudin City Clinical Hospital, Moscow Healthcare Department

Email: golubev194@gmail.com
ORCID iD: 0009-0007-2856-5176
Russian Federation, 4 Kolomenskiy Proezd, Moscow 115446

Ya. I. Suryakhina

S.S. Yudin City Clinical Hospital, Moscow Healthcare Department

Email: golubev194@gmail.com
ORCID iD: 0000-0003-0874-0217
Russian Federation, 4 Kolomenskiy Proezd, Moscow 115446

Zh. I. Banova

S.S. Yudin City Clinical Hospital, Moscow Healthcare Department

Email: golubev194@gmail.com
ORCID iD: 0000-0001-7351-2662
Russian Federation, 4 Kolomenskiy Proezd, Moscow 115446

V. M. Kuzmin

Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: golubev194@gmail.com
ORCID iD: 0009-0000-9658-3586
Russian Federation, Build. 2, 8 Trubetskaya St., Moscow 119048

A. A. Gromov

Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: golubev194@gmail.com
ORCID iD: 0000-0002-3250-9720
Russian Federation, Build. 2, 8 Trubetskaya St., Moscow 119048

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