Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor
Testicular cancer, predominant among young males, poses a significant healthcare challenge with varying incidence rates across European regions. Germ cell tumors (GCTs), constituting 95% of the cases, can be divided into seminoma and non-seminomatous germ cell tumors (NSGCTs). Metastases commonly oc...
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Frontiers Media S.A.
2025-06-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2025.1599413/full |
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| author | Karol Grela Mykola Sobchynskyi Mateusz Piȩtak Barbara Kruczyk Piotr Domański Jakub Kucharz Małgorzata Symonides Tomasz Demkow |
| author_facet | Karol Grela Mykola Sobchynskyi Mateusz Piȩtak Barbara Kruczyk Piotr Domański Jakub Kucharz Małgorzata Symonides Tomasz Demkow |
| author_sort | Karol Grela |
| collection | DOAJ |
| description | Testicular cancer, predominant among young males, poses a significant healthcare challenge with varying incidence rates across European regions. Germ cell tumors (GCTs), constituting 95% of the cases, can be divided into seminoma and non-seminomatous germ cell tumors (NSGCTs). Metastases commonly occur in the lungs, lymph nodes, liver, bone, and brain. This study focuses on a 23-year-old with metastatic NSGCT, who underwent chemotherapy in an intensive care unit setting, followed by a remarkable improvement in his condition. The patient’s initial complaint was persistent abdominal pain, which led to a discovery of an extensive tumor in the abdominal cavity. He underwent cytoreductive surgery, and required admission to an intensive care unit (ICU) due to surgical complications. Histopathology identified a yolk sac tumor. Despite the serious condition, chemotherapy was started. The patient’s condition continued to deteriorate, requiring the initiation of mechanical ventilation. However, the multidisciplinary team opted for a continued treatment. Eventually, the AFP levels started to decrease and a gradual improvement of the patient’s condition have been observed. This allowed to a bleomycin, etoposide, and platinum regimen. Following a complex hospitalization and subsequent surgical resection of residual lesions, the patient remains in good clinical condition. Regular follow-up evaluations have revealed no evidence of disease recurrence. Although NSGCT is characterized by a rather favorable prognosis, it is a significant challenge to clinicians, as the diagnosis is often delayed due to the lack or low specificity of the symptoms. Despite the usually young age of the patients diagnosed with metastatic NSGCT, the patients condition can deteriorate rapidly, presenting with multiorgan failure and a need for an ICU treatment. However, the severity of the patients’ condition should not be unequivocally associated with being not suitable for a systemic curative treatment. Such patients can still benefit from the chemotherapy, and a cooperation between the oncologists and critical care physicians is crucial to improving the outcomes and increase the probability of recovery. |
| format | Article |
| id | doaj-art-04d87f387f224607b3a4f7f2a20c437e |
| institution | OA Journals |
| issn | 2296-858X |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj-art-04d87f387f224607b3a4f7f2a20c437e2025-08-20T02:20:51ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2025-06-011210.3389/fmed.2025.15994131599413Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumorKarol Grela0Mykola Sobchynskyi1Mateusz Piȩtak2Barbara Kruczyk3Piotr Domański4Jakub Kucharz5Małgorzata Symonides6Tomasz Demkow7Department of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandDepartment of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandDepartment of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandDepartment of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandDepartment of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandDepartment of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandClinical Department of Anesthesiology and Intensive Care, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandDepartment of Genitourinary Oncology, Maria Skłodowska-Curie National Research Institute of Oncology, Warsaw, PolandTesticular cancer, predominant among young males, poses a significant healthcare challenge with varying incidence rates across European regions. Germ cell tumors (GCTs), constituting 95% of the cases, can be divided into seminoma and non-seminomatous germ cell tumors (NSGCTs). Metastases commonly occur in the lungs, lymph nodes, liver, bone, and brain. This study focuses on a 23-year-old with metastatic NSGCT, who underwent chemotherapy in an intensive care unit setting, followed by a remarkable improvement in his condition. The patient’s initial complaint was persistent abdominal pain, which led to a discovery of an extensive tumor in the abdominal cavity. He underwent cytoreductive surgery, and required admission to an intensive care unit (ICU) due to surgical complications. Histopathology identified a yolk sac tumor. Despite the serious condition, chemotherapy was started. The patient’s condition continued to deteriorate, requiring the initiation of mechanical ventilation. However, the multidisciplinary team opted for a continued treatment. Eventually, the AFP levels started to decrease and a gradual improvement of the patient’s condition have been observed. This allowed to a bleomycin, etoposide, and platinum regimen. Following a complex hospitalization and subsequent surgical resection of residual lesions, the patient remains in good clinical condition. Regular follow-up evaluations have revealed no evidence of disease recurrence. Although NSGCT is characterized by a rather favorable prognosis, it is a significant challenge to clinicians, as the diagnosis is often delayed due to the lack or low specificity of the symptoms. Despite the usually young age of the patients diagnosed with metastatic NSGCT, the patients condition can deteriorate rapidly, presenting with multiorgan failure and a need for an ICU treatment. However, the severity of the patients’ condition should not be unequivocally associated with being not suitable for a systemic curative treatment. Such patients can still benefit from the chemotherapy, and a cooperation between the oncologists and critical care physicians is crucial to improving the outcomes and increase the probability of recovery.https://www.frontiersin.org/articles/10.3389/fmed.2025.1599413/fulltesticular cancergerm cell tumorintensive care unitchemotherapydialysis |
| spellingShingle | Karol Grela Mykola Sobchynskyi Mateusz Piȩtak Barbara Kruczyk Piotr Domański Jakub Kucharz Małgorzata Symonides Tomasz Demkow Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor Frontiers in Medicine testicular cancer germ cell tumor intensive care unit chemotherapy dialysis |
| title | Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor |
| title_full | Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor |
| title_fullStr | Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor |
| title_full_unstemmed | Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor |
| title_short | Salvage chemotherapy in the intensive care unit: a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor |
| title_sort | salvage chemotherapy in the intensive care unit a case report of successful treatment of a critically ill patient with metastatic testicular germ cell tumor |
| topic | testicular cancer germ cell tumor intensive care unit chemotherapy dialysis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2025.1599413/full |
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