Severe multiorgan toxicities after the first cycle of standard-dose etoposide–cisplatin therapy for metastatic nonseminoma successfully managed with etoposide–carboplatin: a case report

This case demonstrates that even a standard-dose, first-cycle etoposide and cisplatin regimen can trigger abrupt, life-threatening multiorgan toxicities affecting renal, hepatic, auditory, hematologic, and visual systems. Such early, simultaneous onset has rarely been described in scientific literature. When cisplatin continuation is unsafe, etoposide-carboplatin may serve as a feasible alternative to achieve remission while minimizing systemic toxicity. Careful evaluation of patient-specific risk factors, including hypertension, renal reserve, and renin-angiotensin system inhibitor use, is essential before initiating cisplatin-based therapy. This case highlights the importance of individualized treatment planning and prompt recognition of severe chemotherapy-induced toxicities.