{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:42:01Z","timestamp":1764844921858,"version":"3.46.0"},"reference-count":31,"publisher":"Anderson Publishing, Ltd.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["ARO"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Management of testicular germ cell tumors in patients with complex comorbidities remains challenging. We present a case of stage IIB seminoma in a patient with Down syndrome (DS) and Eisenmenger syndrome (ES).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 37-year-old man with DS and ES underwent radical orchiectomy for a testicular mass, confirming seminoma (pT2N2M0R0S0). Following disease progression during surveillance, external beam radiation therapy (36 Gy in 18 fractions) was administered using a dog-leg field technique, as both chemotherapy and surgery were contraindicated. Treatment was well-tolerated with only mild nausea. Follow-up imaging showed near-complete response at 4 months, with stable disease at 12-month follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case demonstrates radiation therapy as an effective, well-tolerated treatment for stage IIB seminoma. Despite theoretical concerns regarding radiosensitivity in DS and the hemodynamic risks of thoracic irradiation in ES, standard para-aortic\/iliac radiation was delivered safely, achieving disease control without unexpected toxicity.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.37549\/aro-d-25-0019","type":"journal-article","created":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T10:39:01Z","timestamp":1764844741000},"page":"1-5","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of Stage IIB Seminoma in a Patient With Down Syndrome and Eisenmenger Syndrome: A Case Report"],"prefix":"10.37549","volume":"1","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8982-7746","authenticated-orcid":false,"given":"Catarina","family":"van der Elzen","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5158-962X","authenticated-orcid":false,"given":"Lurdes","family":"Alves Vendeira","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3745-794X","authenticated-orcid":false,"given":"Rui","family":"Pinto","sequence":"additional","affiliation":[]}],"member":"23686","published-online":{"date-parts":[[2025,12]]},"reference":[{"issue":"9","key":"R1","doi-asserted-by":"publisher","first-page":"1713","DOI":"10.1007\/s00018-019-03022-7","article-title":"Testicular germ cell tumor: a comprehensive review","volume":"76","author":"Batool","journal-title":"Cell Mol Life Sci"},{"key":"R2","unstructured":"Rajpert-De Meyts E Aksglaede L Bandak M et al. 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