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Due to haemodynamic instability, he received therapeutic anticoagulation and an abridged \u2018cycle 0\u2019 chemotherapy regimen, followed by standard bleomycin, etoposide and cisplatin and delayed orchiectomy. Despite the extent of vascular involvement, near-complete resolution of tumour thrombus was achieved without surgical thrombectomy. This case highlights the potential for medical therapy alone in select non-seminomatous germ cell tumours and underscores the importance of early systemic treatment and multidisciplinary coordination. We also detail key complicating features such as suspicion of antithrombin consumption challenging our anticoagulation strategy to inform management strategies.<\/jats:p>","DOI":"10.1136\/bcr-2025-266237","type":"journal-article","created":{"date-parts":[[2025,7,5]],"date-time":"2025-07-05T09:45:12Z","timestamp":1751708712000},"page":"e266237","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Near-complete resolution of tumour thrombus in a patient with advanced non-seminomatous germ cell tumour: a multidisciplinary approach without surgical intervention"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2572-7711","authenticated-orcid":false,"given":"Alicia","family":"Hou","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3850-834X","authenticated-orcid":false,"given":"Akshay","family":"Mathavan","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3496-2542","authenticated-orcid":false,"given":"Akash","family":"Mathavan","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan A","family":"Chatzkel","sequence":"additional","affiliation":[{"name":"Medical Oncology, University of Florida Health, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,5]]},"reference":[{"key":"2025082804352851000_18.7.e266237.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2011.05.004"},{"key":"2025082804352851000_18.7.e266237.2","doi-asserted-by":"crossref","first-page":"754","DOI":"10.1016\/S0140-6736(06)68305-0","article-title":"Testicular germ-cell cancer","volume":"367","author":"Horwich","year":"2006","journal-title":"The Lancet"},{"key":"2025082804352851000_18.7.e266237.3","doi-asserted-by":"crossref","DOI":"10.1200\/JCO.2024.42.16_suppl.e17018","article-title":"Prognostic factors and survival in men with testicular germ cell tumors (GCT)","volume":"42","author":"Zagoruiko","year":"2024","journal-title":"JCO"},{"key":"2025082804352851000_18.7.e266237.4","doi-asserted-by":"crossref","first-page":"1535","DOI":"10.1007\/s00345-019-02927-z","article-title":"Contemporary North-American population-based validation of the International Germ Cell Consensus Classification for metastatic germ cell tumors of the testis","volume":"38","author":"Mazzone","year":"2020","journal-title":"World J Urol"},{"key":"2025082804352851000_18.7.e266237.5","doi-asserted-by":"crossref","unstructured":"Xu P , Wang J , Abudurexiti M , et al . 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