Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report

Background/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clin...

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Main Authors: Iuliana Pantelimon, Andra-Maria Stancu, Claudiu Socoliuc, Fikirie Abzait, Irina Balescu, Nicolae Bacalbasa, Cristian Balalau, Laurenţia Nicoleta Galeș, Iulian Brezean
Format: Article
Language:English
Published: MDPI AG 2025-05-01
Series:Journal of Mind and Medical Sciences
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Online Access:https://www.mdpi.com/2392-7674/12/1/30
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author Iuliana Pantelimon
Andra-Maria Stancu
Claudiu Socoliuc
Fikirie Abzait
Irina Balescu
Nicolae Bacalbasa
Cristian Balalau
Laurenţia Nicoleta Galeș
Iulian Brezean
author_facet Iuliana Pantelimon
Andra-Maria Stancu
Claudiu Socoliuc
Fikirie Abzait
Irina Balescu
Nicolae Bacalbasa
Cristian Balalau
Laurenţia Nicoleta Galeș
Iulian Brezean
author_sort Iuliana Pantelimon
collection DOAJ
description Background/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clinical manifestations, prompting emergent extensive surgical intervention. Upon admission to the Oncology Department, the adolescent presented with jaundice and dyspnea, being diagnosed with pure non-seminomatous embryonal carcinoma, a poor-risk prognosis group. Based on his prognostic group, the patient should have undergone chemotherapy with a well standardized regimen, but the imminent “liver visceral crisis” did not allow for the standard dose chemotherapy administration, so an adapted regimen of chemotherapy was considered and the full number of cycles was applied after this induction cycle. The treatment journey was protracted, emphasizing the need for early recognition and intervention in such cases. A comprehensive ongoing evaluation, including imagistic examinations and laboratory tests, revealed the presence of extensive refractory disease, which led to urgent treatment. Conclusions: This case provides valuable insights into the management of advanced testicular germ cell tumor in young patients facing imminent organ failure and underlines the importance of interdisciplinary collaboration. Understanding the complexities of this condition can aid in improving patient outcomes and enhancing the quality of care provided.
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spelling doaj-art-d90bcf9ae4a042d5940582c3bcd00e7c2025-08-20T03:27:37ZengMDPI AGJournal of Mind and Medical Sciences2392-76742025-05-011213010.3390/jmms12010030Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case ReportIuliana Pantelimon0Andra-Maria Stancu1Claudiu Socoliuc2Fikirie Abzait3Irina Balescu4Nicolae Bacalbasa5Cristian Balalau6Laurenţia Nicoleta Galeș7Iulian Brezean8Department of Oncology, “Dr. I. Cantacuzino” Clinical Hospital, 073206 Bucharest, RomaniaDepartment of Oncology, “Dr. I. Cantacuzino” Clinical Hospital, 073206 Bucharest, RomaniaDepartment of Pathology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Radiology, “Dr. I. Cantacuzino” Clinical Hospital, 073206 Bucharest, RomaniaDepartment of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Oncology, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaDepartment of Surgery, “Carol Davila” University of Medicine and Pharmacy, 050474 Bucharest, RomaniaBackground/Aim: This case report navigates through the challenges of a complex clinical scenario involving germ cell tumors (GCTs), one of the most frequently encountered malignancies in adolescents and young adults. Case report: We present the case of an 18-year-old patient exhibiting atypical clinical manifestations, prompting emergent extensive surgical intervention. Upon admission to the Oncology Department, the adolescent presented with jaundice and dyspnea, being diagnosed with pure non-seminomatous embryonal carcinoma, a poor-risk prognosis group. Based on his prognostic group, the patient should have undergone chemotherapy with a well standardized regimen, but the imminent “liver visceral crisis” did not allow for the standard dose chemotherapy administration, so an adapted regimen of chemotherapy was considered and the full number of cycles was applied after this induction cycle. The treatment journey was protracted, emphasizing the need for early recognition and intervention in such cases. A comprehensive ongoing evaluation, including imagistic examinations and laboratory tests, revealed the presence of extensive refractory disease, which led to urgent treatment. Conclusions: This case provides valuable insights into the management of advanced testicular germ cell tumor in young patients facing imminent organ failure and underlines the importance of interdisciplinary collaboration. Understanding the complexities of this condition can aid in improving patient outcomes and enhancing the quality of care provided.https://www.mdpi.com/2392-7674/12/1/30embryonal carcinomatesticular cancervisceral crisismetastasesinduction chemotherapyhigh-dose chemotherapy
spellingShingle Iuliana Pantelimon
Andra-Maria Stancu
Claudiu Socoliuc
Fikirie Abzait
Irina Balescu
Nicolae Bacalbasa
Cristian Balalau
Laurenţia Nicoleta Galeș
Iulian Brezean
Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
Journal of Mind and Medical Sciences
embryonal carcinoma
testicular cancer
visceral crisis
metastases
induction chemotherapy
high-dose chemotherapy
title Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
title_full Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
title_fullStr Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
title_full_unstemmed Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
title_short Challenges in the Treatment of a Refractory Testicular Germ Cell Tumor in Young Patients with Imminent Organ Failure—A Case Report
title_sort challenges in the treatment of a refractory testicular germ cell tumor in young patients with imminent organ failure a case report
topic embryonal carcinoma
testicular cancer
visceral crisis
metastases
induction chemotherapy
high-dose chemotherapy
url https://www.mdpi.com/2392-7674/12/1/30
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