In the nick of time: arterial thrombosis on starting combination chemotherapy in metastatic gastric adenocarcinoma

A 70-year-old man newly diagnosed with metastatic gastric adenocarcinoma was started on standard first-line palliative chemotherapy with anthracycline (epirubicin), platinum (oxaliplatin) and fluoropyrimidine (capecitabine); EOX combination chemotherapy. 5 days after the first cycle of chemotherapy,...

Full description

Saved in:
Bibliographic Details
Published in:BMJ case reports 2016-02, Vol.2016, p.bcr2015214236
Main Authors: Boon, Ian S, Boon, Cheng S
Format: Article
Language:English
Subjects:
Abdomen
Aged
Anticoagulants - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Chemotherapy
Cholecystectomy
Coronary vessels
Cytotoxicity
Enoxaparin - administration & dosage
Gastric cancer
Humans
Male
Medical prognosis
Metastasis
Palliative Care
Stomach Neoplasms - blood
Stomach Neoplasms - diagnostic imaging
Stomach Neoplasms - drug therapy
Thromboembolism
Thrombosis
Thrombosis - chemically induced
Thrombosis - drug therapy
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
United Kingdom
White
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:A 70-year-old man newly diagnosed with metastatic gastric adenocarcinoma was started on standard first-line palliative chemotherapy with anthracycline (epirubicin), platinum (oxaliplatin) and fluoropyrimidine (capecitabine); EOX combination chemotherapy. 5 days after the first cycle of chemotherapy, he presented with tachycardia with associated severe abdominal and lumbar pains. Initial investigations confirmed life-threatening metabolic acidosis with serum lactate of 9.7 mmol/L (normal range 0.5–2.2 mmol/L). CT angiogram identified acute arterial thrombosis within the abdominal aorta, lumbar and right common iliac artery, which was absent on staging contrast CT scan 6 weeks prior. The patient was immediately anticoagulated and chemotherapy discontinued. Urgent oncology and surgical opinions advised conservative management. The patient responded well to early treatment and survived this acute episode. He was subsequently started on life-long treatment dose enoxaparin and second-line single agent chemotherapy with docetaxel (taxotere), with no reported complications.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2015-214236