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Topics:
Genitourinary Cancers • Medical Oncology • Testicular Cancer • Germ Cell Tumors • Anticoagulation
How would you approach therapy for a patient with non-seminomatous germ cell tumor, cT3N3Mx and symptomatic lower extremity thrombus extending to the IVC when it is unclear if bland or tumor thrombus?
HCG 850, AFP normal, LDH ~500 pre-orchiectomy.
If tumor thrombus, would you favor 4c of BEP? Would you try biopsy it? How common is IVC thrombus with testicular cancer?
Answer from: Medical Oncologist at Community Practice
This is not a common setting, but it is well described and high volume centers have fairly uniform approaches to patients presenting with caval thrombus. With the pre-orch HCG of 850, he is likely IGCCC good risk unless he is found to have brain or hepatic mets. He is likely non seminoma with a larg...
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