Testicular cancer with extensive gonadal and renal vein tumor thrombus

Tumor thrombus has been demonstrated to occur with hepatocellular and renal cell carcinoma, however, rarely occurs in testicular germ cell malignancies. Tumor thrombus results from the intravascular invasion of malignant cells, different from the hypercoagulable state induced by malignancy, and has significant implications with regards to prognosis and therapeutic options. We describe a case of an otherwise healthy 30-year-old patient with extensive gonadal and renal vein tumor thrombus from testicular germ cell cancer, as well as discuss the diagnosis and treatment options for this type of metastatic disease. •Tumor thrombus is a rare presentation of metastatic embryonal carcinoma.•Chemotherapy, rather than anticoagulation, is the preferred treatment of tumor thrombus.•Imaging assessment of the gonadal vein is vital in patients with angioinvasive tumor.