RESUMO
We presented the case of a 63-year-old woman with severe abdominal distention due to recurrent retroperitoneal sarcoma. Further, the rapid progression of the tumor made it difficult to relieve the abdominal distention. Titrated intravenous morphine was administered. Although the dose of morphine was escalated and the patient was sedated, she continued to experience pain. The addition of a continuous epidural analgesic lidocaine to manage the abdominal distention was effective. This case report describes a stepwise approach with continuous epidural analgesia of lidocaine for a bulky tumor- related abdominal distention.
Assuntos
Analgesia Epidural , Analgésicos Opioides , Feminino , Humanos , Lidocaína , Pessoa de Meia-Idade , Morfina , Recidiva Local de Neoplasia , DorRESUMO
The rate of metastasis to the central nervous system is high in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer patients. Metastatic cauda equina tumors are characterized by rapid progression of symptoms, thus signifying the requirement of their early treatment. However, these tumors are rarely reported, and their optimal treatment options have not been established yet. Here, we report a case study of a patient with HER2-positive breast cancer that metastasized to the cauda equina. The patient underwent urgent surgery to relieve the spinal cord compression. The pain in her back and lower limbs was greatly reduced. Unfortunately, her ability to walk did not improve sufficiently. Overall, surgical treatment may be a favorable option to improve a patient's quality of life.
Assuntos
Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/secundário , Neoplasias do Sistema Nervoso Periférico/secundário , Carcinoma Ductal de Mama/patologia , Cauda Equina/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Compressão da Medula Espinal/etiologiaRESUMO
A new supportive method of centrifugal left heart bypass with oxygenation was performed in 25 patients and compared with standard left heart bypass in 45 patients. Femoro-femoral bypass was selected in another 6 patients because of the presence of a left atrial adhesion. Intraoperative complications related to standard left heart bypass, hypoxia, hypothermia, and ventricular fibrillation, were eliminated by using this method. This supportive method maintained good hemodynamics and improved the surgical result of extended thoracoabdominal aortic replacement. Hospital deaths decreased from 6.7% to 3.2%.