Preoperative radiation as part of a multidisciplinary strategy for a medically inoperable patient with a bleeding colon cancer

BMJ Case Rep. 2019 Aug 21;12(8):e229488. doi: 10.1136/bcr-2019-229488.

Abstract

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.

Keywords: cancer intervention; colon cancer; gastrointestinal surgery; heart failure; radiotherapy.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Colectomy
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / diagnosis*
  • Colonic Neoplasms / diagnostic imaging
  • Colonic Neoplasms / therapy
  • Combined Modality Therapy
  • Gastrointestinal Hemorrhage / etiology
  • Heart Failure*
  • Humans
  • Male
  • Neoadjuvant Therapy
  • Patient Care Team
  • Stents
  • Tomography, X-Ray Computed