Case report demonstrates successful synchronous pulmonary endarterectomy and hepatic resection in advanced colorectal cancer, indicating dual surgery can resolve life-threatening complications.
Introduction: The survival time of recurrent cases of colorectal cancer has been prolonged by effective chemotherapy. However, side effects sometimes occur, which can be life-threatening condition. Case Report: A 66-year-old female was admitted to our hospital complaining of dyspnea on effort and abdominal distension. Twenty-three months before admission, she had undergone anterior resection for recto-sigmoid cancer. After anterior resection, adjuvant chemotherapy was performed. However, hepatic and pulmonary metastases were detected three months after starting adjuvant chemotherapy. She had been treated with chemotherapy for 22 months because of metastases before admission. 4 months before admission, she had experienced dyspnea on effort caused of bilateral pulmonary embolism and the symptom had continued. Computed tomography showed two metastatic tumors in the liver, with diameters of 6.5 cm in S8 and 4.5 cm in S3, as well as bilateral pulmonary arterial embolism. From general condition, it was considered that surgical treatment could be tolerated. Bilateral pulmonary arterial endarterectomy and hepatic metastasectomy were performed, because the bilateral pulmonary thromboembolism and hepatic metastases were considered to be life-threatening. The postoperative course was uneventful and she was discharged from hospital on the 15th postoperative day. Conclusion: Synchronous endarterectomy and metastasectomy contributed to improve the patient's QOL. If this side effect is considered to be potentially fatal, the removal of the embolism is the treatment of choice.
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Maekawa et al. (2015) studied this question.
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