A Case of Transverse Colon Cancer Diagnosed in a Patient with Symptomatic Pulmonary Embolism Successfully Resected by Laparoscopic Surgery

Abstract

A 77-year-old woman was admitted to our institution complaining of palpitation and dyspnea. She was diagnosed as having acute pulmonary embolism and deep vein thrombosis in the left leg by computed tomography. Anticoagulant therapy was started immediately. Laboratory examination revealed anemia and the patient was diagnosed as having transverse colon cancer based on the findings of abdominal ultrasonography and colonoscopy. After confirming lysis of the thrombus in the pulmonary artery, laparoscopic surgery was performed after placement of a vena cava filter. To prevent recurrent pulmonary embolism, not only anticoagulant therapy was continued, but an Enhanced recovery after surgery (ERAS) program was incorporated into the perioperative management. Consequently, the patient showed no symptoms of pulmonary embolism during the postoperative course. Adequate knowledge and careful treatment are required for colon cancer patients with acute pulmonary embolism, which can be fatal. Herein, we report a case of transverse colon cancer with acute pulmonary embolism that was treated by successful perioperative management, including anticoagulant therapy, placement of a vena cava filter, institution of an ERAS program, and laparoscopic surgery; we also review 12 previously reported Japanese cases of colon cancer with pulmonary embolism that were treated by surgery.