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Case Report
Significant cisplatin-associated carotid artery thrombosis treated and successfully rechallenged with cisplatin in a patient with testicular cancer
1 Lithuanian University of Health Sciences, 5th year Medicine, Kaunas, Lithuania
2 Medical Oncology Department, University Hospital Limerick, Ireland
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N Osman
Medical Oncology Department, University Hospital Limerick,
Ireland
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Article ID: 100160Z10MO2026
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Osman M, Dunne K, Mohammad ME, Osman N. Significant cisplatin-associated carotid artery thrombosis treated and successfully rechallenged with cisplatin in a patient with testicular cancer. J Case Rep Images Oncology 2026;12(2):13–18.ABSTRACT
Introduction: Cisplatin-based systemic chemotherapy remains the cornerstone of treatment of testicular germ cell tumors, yet it carries a significant risk of thromboembolic complications. Although venous thromboembolism is more frequently reported, arterial thrombotic events (ATEs)—including ischemic stroke—represent a serious but underrecognized complication that can occur acutely, even after one treatment cycle.
Case Report: This case report describes a 29-year-old male with metastatic mixed germ cell tumor who developed acute left-sided hemiparesis and dysarthria on day 7 of cycle one etoposide-cisplatin. Imaging revealed total right internal carotid artery occlusion with evolving middle cerebral territory infarction. The patient underwent urgent thrombolysis and thrombectomy with excellent neurological recovery and complete resolution of deficits. Potential contributing factors included a history of smoking and chronic tonsilitis. Following repeated multidisciplinary discussions, the patient was rechallenged with further three cycles of cisplatin and etoposide concurrently with anticoagulation and close monitoring. He achieved a complete biochemical response and subsequently complete radiological response after retroperitoneal lymph node dissection (RPLND).
Conclusion: This case report raises few critical points: including the importance of maintaining high index of suspicion for acute thromboembolism, particularly in patients with associated risk factors; the paramount value of various multidisciplinary team members, including stroke team, interventional radiology and neurology services; and the rechallenge with cisplatin remains the most critical decision. The use of carboplatin for cisplatin not only offers inferior results but may even be associated with higher thromboembolic risk and finally given the curative treatment intention in this young, otherwise healthy young population, continued appropriate anticoagulation therapy with vigilant monitoring represent fundamental approach. Our case adds to the sparse data on cisplatin-associated arterial thromboembolism and highlight the urgent need for universal management guidelines.
Keywords: Cisplatin, Stroke, Testicular cancer, Thrombosis
SUPPORTING INFORMATION
Acknowledgments
We acknowledge our patient who gave a consent, our multidisciplinary team members and radiology department at University Hospital Cork, Ireland.
Author ContributionsM Osman - Acquisition of data, Drafting the article, Final approval of the version to be published
K Dunne - Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
ME Mohammad - Acquisition of data, Drafting the article, Final approval of the version to be published
N Osman - Substantial contributions to conception and design, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2026 M Osman et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
