Preoperative radiation as part of a multidisciplinary strategy for a medically inoperable patient with a bleeding colon cancer.
June S PengNeha L LadEdward J SpangenthalDavid M MattsonSteven J NurkinPublished in: BMJ case reports (2019)
An 84-year-old man with a history of deep vein thrombosis on warfarin and coronary artery disease presented with haematochezia and was diagnosed with an ascending colon cancer. He was short of breath with lower extremity oedema at the initial surgical consultation. Evaluation revealed an acute exacerbation of congestive heart failure, and further workup and treatment were recommended by the cardiology team. After multidisciplinary discussion, he underwent radiation for the control of bleeding, followed by cardiac catheterisation and placement of a bare metal stent. The patient subsequently underwent robotic-assisted right hemicolectomy. Pathology demonstrated a complete response, and the patient recovered uneventfully. He is alive swith no evidence of disease recurrence 12 months after surgery and 18 months after initial diagnosis.
Keyphrases
- heart failure
- atrial fibrillation
- coronary artery disease
- case report
- palliative care
- left ventricular
- quality improvement
- respiratory failure
- liver failure
- venous thromboembolism
- type diabetes
- cardiovascular disease
- squamous cell carcinoma
- locally advanced
- intensive care unit
- radiation induced
- hepatitis b virus
- aortic dissection
- ejection fraction
- drug induced
- replacement therapy
- mechanical ventilation
- acute heart failure
- aortic stenosis