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Japanese Journal of Clinical Oncology Advance Access published online on August 24, 2006
Japanese Journal of Clinical Oncology, doi:10.1093/jjco/hyl078
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© 2006 Foundation for Promotion of Cancer Research
Received March 6, 2006
Accepted May 1, 2006

Case Report

A Case of Metastatic Testicular Cancer Complicated by Tumour Lysis Syndrome and Choriocarcinoma Syndrome

Koji Kawai 1 *, Ei-Ichiro Takaoka 1, Makito Naoi 1, Kensaku Mori 2, Manabu Minami 2, Toru Shimazui 1, and Hideyuki Akaza 1

1 Department of Urology, Institute of Clinical Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki, Japan
2 Department of Radiology, Institute of Clinical Medicine, University of Tsukuba Graduate School of Comprehensive Human Sciences, Tsukuba, Ibaraki, Japan

* To whom correspondence should be addressed.
Koji Kawai, E-mail: rkawa{at}md.tsukuba.ac.jp


  Abstract

A 26-year-old man was referred to our hospital for treatment of metastatic testicular cancer. The pathological diagnosis was choriocarcinoma with seminoma. Sequential computerized tomography examinations revealed rapidly progressing bulky liver metastases and a lung metastasis. Chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started on the day of admission. Subsequently, the patient suffered from tumour lysis syndrome (TLS) and massive haemorrhage at metastatic sites. The latter complication is also called choriocarcinoma syndrome. To our knowledge, this is the first case report of testicular cancer complicated with both critical conditions. Intensive care and radiological intervention barely prevented a fatal outcome. The urological oncologist should be aware of the potential complications TLS and choriocarcinoma syndrome in cases of rapidly progressive and high-volume choriocarcinoma.

Keywords: testicular cancer; tumour lysis syndrome; choriocarcinoma syndrome.
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