Testicular germ-cell carcinoma (TGCC) is curable. Three-drug combination chemotherapy for testicular tumors (BEP therapy: bleomycin, etoposide, and cisplatin) is performed as standard treatment following orchiectomy. A 21- year- old male had a hard painless left testicular lump for two months. Investigations revealed elevated levels of serum betaHCG and alpha-fetoprotein. Testicular tumor with left para aortic lymph node involvement was diagnosed after a CT scan. Left inguinal radical orchiectomy was performed and histology revealed that mixed germ cell tumor composed predominantly of yolk sac carcinoma (50%) associated with seminoma (30%) and embryonic carcinoma (20%). The oncologist decided to treat him with four cycles of chemotherapy with BEP regime. He was given the first chemotherapy. However, he was found collapsed before completion of the second cycle of chemotherapy in the ward bath room. Autopsy revealed that total alopecia, hypo pigmented healed marks of chickenpox and left inguinal scar with absence of the testis. Serial dissection of left common trunk and anterior descending branch of coronary arteries revealed a thrombus completely occluding the lumen. Yellowish necrotic area with intermittent fresh hemorrhages were found in the anterior and posterolateral walls of left ventricle. There were no risk factors or family history for premature coronary events. End of the autopsy, the cause of death was given as acute myocardial infarction due to coronary thrombus in a subject with chemotherapy for testicular carcinoma. This case strengthens the previous studies of induction of Virchow’s triad and early formation of thrombus with myocardial events during the chemotherapy for testicular carcinoma. This case report reiterates the importance of cardiac assessment prior to chemotherapy to avoid unnecessary litigation cases

Keywords : Chemotherapy, BEP, Myocardial Infarction, Testicular Cancer, Thromboembolism, Medical Negligence, Forensic Pathologist