Abstract
Near-fatal saddle pulmonary embolism following chemoradiotherapy and brachytherapy for locally advanced cervical cancer: A case series
- Department of Obstetrics and Gynecology, Catharina Cancer Institute, Catharina Hospital, Eindhoven, the Netherlands
- GROW – Research Institute for Oncology and Reproduction, Maastricht University, the Netherlands
- Department of Intensive Care, Catharina Hospital, Eindhoven, the Netherlands
- Department of Radiation Oncology, Institute Verbeeten, Tilburg, the Netherlands
- Department of Radiology, Catharina Hospital, Eindhoven, the Netherlands
- Department of Gynecology, Radboudumc, Nijmegen, the Netherlands
- Department of Radiation Oncology, Catharina Hospital, Eindhoven, the Netherlands
Purpose:
Women with locally advanced cervical cancer treated with chemoradiotherapy followed by brachytherapy are at increased risk of venous thromboembolic events.
Case presentation:
This case series reported three women, who experienced near-fatal saddle pulmonary embolisms shortly after undergoing high-dose-rate brachytherapy for locally advanced cervical cancer. In one patient, pulmonary saddle embolism led to hypovolemic shock due to intra-abdominal hemorrhage post-resuscitation, necessitating emergency decompressive laparotomy. Another case was complicated by neurological symptoms consistent with a stuttering stroke, following mechanical pulmonary thrombectomy.
Conclusions:
Pulmonary embolism represents a severe complication of chemoradiotherapy and brachytherapy. Given the high morbidity and mortality rates associated with this condition, routine thromboprophylaxis may be warranted.
Keywords
cervical cancer, saddle pulmonary embolism, brachytherapy, chemoradiotherapy, thromboprophylaxis
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