ABSTRACT
Anaplastic thyroid carcinoma is a rare tumor, consisting 1-2% of all thyroid malignancies and presenting a high mortality rate. Median survival for patients undergoing primary surgery is approximately 6.6 months. We present a case of a patient treated with R0 resection, including total thyroidectomy and lymphadenectomy of levels III, IV, VI and VII after cervical lymph node mapping, oral 131I administration, and radiotherapy. Proper preoperative research, R0 resection and relatively early diagnosis, led to good prognosis, as the patient is currently totally disease-free, twelve months postoperatively.
ABSTRACT
We describe a case of massive intraoperative pulmonary thromboembolism during elective sigmoidectomy in the supine position. During recovery from anesthesia, the patient developed hemodynamic compromise and severe hypoxemia. Intravenous inotropes and mechanical ventilation were instituted. The abrupt onset of symptoms and the pulmonary artery catheter, chest radiograph, and transesophageal echocardiography findings suggested massive pulmonary thromboembolism as a possible cause of the hemodynamic compromise and hypoxemia. Emergent angiography could not be carried out due to the patient's poor clinical status. Lack of experience in performing embolectomy, along with contraindication for thrombolysis, imposed the use of intravenous heparin and hemodynamic support as the only appropriate therapeutic modality. After 2 days' aggressive hemodynamic and ventilatory support, the patient had an uneventful course, and was discharged from the intensive care unit (ICU) 14 days later.
