More Than Meets The Eye
Lack of control of lower limbs reveals a set of much
more deeper problems
A 25-year old man was brought to the Emergency Department of
BLK Super Speciality Hospital with complaints of sudden loss of
power in both his lower limbs. The MRI spine revealed multiple
vertebral lesions with spinal cord compression. He was taken up
immediately for decompression surgery. Medical oncology opinion
was sought for testicular swelling and bone metastasis. The patient
needed further assessment and treatment for advanced stage
Testicular Malignancy, Septicemia, Tumour Lysis Syndrome, Renal
Dysfunction and Paraplegia.
All his tumour markers (AFP, beta HCG, LDH) were elevated. PETCT
non-contrast revealed right Testicular Tumour with metastasis to
liver and multiple bones. The family was counselled for the treatment
The patient was started under high risk consent on low dose
chemotherapy with all supportive care measures for his conditions.
Gradually he started showing improvement. Renal function showed
improvement and complete recovery over 2 weeks. Once his general
condition started improving, he was administered complete two
courses of chemotherapy. In view of deep vein thrombosis, IVC fi lter
was inserted by the Cardiologist.
Re-evaluation after two cycles of chemotherapy revealed complete
remission of his disease. The patient was given two more cycles of
chemotherapy and he continued to be in complete remission. He
started showing improvement in controlling his lower limbs after 2
cycles of chemotherapy.
He underwent right orchiectomy after the complete treatment.
The histopathology of specimen showed pathological complete
The patient showed tremendous improvement after 4 cycles of
chemotherapy and he could come to the follow-up OPD walking on
his own with support. He is under regular follow-up now. It has been
more than 18 months and he is currently disease free.