Skip to main content
Top
Published in: World Journal of Surgical Oncology 1/2006

Open Access 01-12-2006 | Case report

Cerebral edema in a patient following cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemoperfusion

Authors: Rajalakshmi L Nair, Jonathan Tobias, Grant Stemmerman, Andrew M Lowy

Published in: World Journal of Surgical Oncology | Issue 1/2006

Login to get access

Abstract

Background

Cytoreductive surgery and intraoperative, intraperitoneal hyperthermic chemoperfusion (HIPEC) is increasingly used to treat peritoneal surface metastases. We describe a fatal case of cerebral edema in a patient with appendiceal carcinoma and an underlying seizure disorder who underwent cytoreductive surgery and HIPEC.

Case presentation

A case of fatal postoperative cerebral edema is presented in a patient with an underlying seizure disorder and recurrent mucinous adenocarcinoma of the appendix. The patient was treated with cytoreductive surgery and intraoperative intraperitoneal hyperthermic chemoperfusion. The details and implications of this complication are discussed.

Conclusion

The recognition of this potential complication is important for physicians performing cytoreductive surgery and HIPEC. Special caution should be taken when patients with seizure disorders are being considered for this treatment.
Appendix
Available only for authorised users
Literature
1.
go back to reference Stewart JH, Shen P, Levine EA: Intraperitoneal chemotherapy for peritoneal surface malignancy: current status and future directions. Ann Surg Oncol. 2005, 12: 765-777. 10.1245/ASO.2005.12.001.CrossRefPubMed Stewart JH, Shen P, Levine EA: Intraperitoneal chemotherapy for peritoneal surface malignancy: current status and future directions. Ann Surg Oncol. 2005, 12: 765-777. 10.1245/ASO.2005.12.001.CrossRefPubMed
2.
go back to reference Glehen O, Kwiatkowski M, Sugarbaker PH, Elias D, Levine EA, Gilly FN, De Simone M, Barone R, Yonemura Y, Cavaliere F, Quenet F, Gutman M, Tentes AAK, Lorimier G, Bernard JL, Bereder JM, Porcheron J, Gomez-Portilla A, Shen P, Deraco M, Rat P: Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol. 2004, 22: 3284-3292. 10.1200/JCO.2004.10.012.CrossRefPubMed Glehen O, Kwiatkowski M, Sugarbaker PH, Elias D, Levine EA, Gilly FN, De Simone M, Barone R, Yonemura Y, Cavaliere F, Quenet F, Gutman M, Tentes AAK, Lorimier G, Bernard JL, Bereder JM, Porcheron J, Gomez-Portilla A, Shen P, Deraco M, Rat P: Cytoreductive surgery combined with perioperative intraperitoneal chemotherapy for the management of peritoneal carcinomatosis from colorectal cancer: a multi-institutional study. J Clin Oncol. 2004, 22: 3284-3292. 10.1200/JCO.2004.10.012.CrossRefPubMed
3.
go back to reference Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Copeland LJ, Walker JL, Burger RA, Gynecologic Oncology Group: Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006, 354: 34-43. 10.1056/NEJMoa052985.CrossRefPubMed Armstrong DK, Bundy B, Wenzel L, Huang HQ, Baergen R, Lele S, Copeland LJ, Walker JL, Burger RA, Gynecologic Oncology Group: Intraperitoneal cisplatin and paclitaxel in ovarian cancer. N Engl J Med. 2006, 354: 34-43. 10.1056/NEJMoa052985.CrossRefPubMed
4.
go back to reference Hamilton CA, Berek JS: Intraperitoneal chemotherapy for ovarian cancer. Curr Opin Oncol. 2006, 18: 507-515. 10.1097/01.cco.0000239892.21161.18.CrossRefPubMed Hamilton CA, Berek JS: Intraperitoneal chemotherapy for ovarian cancer. Curr Opin Oncol. 2006, 18: 507-515. 10.1097/01.cco.0000239892.21161.18.CrossRefPubMed
5.
go back to reference Verwaal VJ, van Ruth S, de Bree E, van Sloothen GW, van Tinteren H, Boot H, Zoetmulder FA: Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003, 21: 3737-3743. 10.1200/JCO.2003.04.187.CrossRefPubMed Verwaal VJ, van Ruth S, de Bree E, van Sloothen GW, van Tinteren H, Boot H, Zoetmulder FA: Randomized trial of cytoreduction and hyperthermic intraperitoneal chemotherapy versus systemic chemotherapy and palliative surgery in patients with peritoneal carcinomatosis of colorectal cancer. J Clin Oncol. 2003, 21: 3737-3743. 10.1200/JCO.2003.04.187.CrossRefPubMed
6.
go back to reference Jacks SP, Hundley JP, Shen P, Russell GB, Levine EA: Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma. J Surg Oncol. 2005, 91: 112-7. 10.1002/jso.20296.CrossRefPubMed Jacks SP, Hundley JP, Shen P, Russell GB, Levine EA: Cytoreductive surgery and intraperitoneal hyperthermic chemotherapy for peritoneal carcinomatosis from small bowel adenocarcinoma. J Surg Oncol. 2005, 91: 112-7. 10.1002/jso.20296.CrossRefPubMed
7.
go back to reference Brigand C, Arvieux C, Gilly FN, Glehen O: Treatment of peritoneal carcinomatosis in gastric cancers. Dig Dis. 2004, 22: 366-373. 10.1159/000083600.CrossRefPubMed Brigand C, Arvieux C, Gilly FN, Glehen O: Treatment of peritoneal carcinomatosis in gastric cancers. Dig Dis. 2004, 22: 366-373. 10.1159/000083600.CrossRefPubMed
8.
go back to reference Sugarbaker PH, Chang D: Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy. Ann Surg Oncol. 1999, 6: 727-731. 10.1007/s10434-999-0727-7.CrossRefPubMed Sugarbaker PH, Chang D: Results of treatment of 385 patients with peritoneal surface spread of appendiceal malignancy. Ann Surg Oncol. 1999, 6: 727-731. 10.1007/s10434-999-0727-7.CrossRefPubMed
9.
go back to reference Ahmad SA, Sussman JJ, Kim J, Soldano DA, Pennington L, Lowy AM: Reduced morbidity and mortality following cytoreductive surgery and intraperitoneal hyperthermic perfusion. Ann Surg Oncol. 2004, 11: 387-392. 10.1245/ASO.2004.09.007.CrossRefPubMed Ahmad SA, Sussman JJ, Kim J, Soldano DA, Pennington L, Lowy AM: Reduced morbidity and mortality following cytoreductive surgery and intraperitoneal hyperthermic perfusion. Ann Surg Oncol. 2004, 11: 387-392. 10.1245/ASO.2004.09.007.CrossRefPubMed
10.
go back to reference Smeenk RM, Verwaal VJ, Zoetmulder FA: Toxicity and mortality of cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy in pseudomyxoma peritonei – a report of 103 procedures. Eur J Surg Oncol. 2006, 32: 186-190. 10.1016/j.ejso.2005.08.009.CrossRefPubMed Smeenk RM, Verwaal VJ, Zoetmulder FA: Toxicity and mortality of cytoreduction and intraoperative hyperthermic intraperitoneal chemotherapy in pseudomyxoma peritonei – a report of 103 procedures. Eur J Surg Oncol. 2006, 32: 186-190. 10.1016/j.ejso.2005.08.009.CrossRefPubMed
11.
go back to reference Kanakoudis F, Petrou D, Michaloudis D, Chortaria G, Konstantinidou A: Anaesthesia for intraperitoneal perfusion of hyperthermic chemotherapy. Anaesthesia. 1996, 51: 1033-1036.CrossRefPubMed Kanakoudis F, Petrou D, Michaloudis D, Chortaria G, Konstantinidou A: Anaesthesia for intraperitoneal perfusion of hyperthermic chemotherapy. Anaesthesia. 1996, 51: 1033-1036.CrossRefPubMed
12.
go back to reference Esquivel J, Angulo F, Bland RK, Stephens AD, Sugarbaker PH: Hemodynamic and cardiac function parameters during heated intraoperative intraperitoneal chemotherapy using the open "coliseum technique. Ann Surg Oncol. 2000, 7: 296-300. 10.1007/s10434-000-0296-2.CrossRefPubMed Esquivel J, Angulo F, Bland RK, Stephens AD, Sugarbaker PH: Hemodynamic and cardiac function parameters during heated intraoperative intraperitoneal chemotherapy using the open "coliseum technique. Ann Surg Oncol. 2000, 7: 296-300. 10.1007/s10434-000-0296-2.CrossRefPubMed
13.
go back to reference Fountain NB: Status Epilepticus: Risk factors and complications. Epilepsia. 2000, 41: 23-30. 10.1111/j.1528-1157.2000.tb01521.x.CrossRef Fountain NB: Status Epilepticus: Risk factors and complications. Epilepsia. 2000, 41: 23-30. 10.1111/j.1528-1157.2000.tb01521.x.CrossRef
14.
go back to reference Nelson SR, Olson JP: Role of early edema in the development of regional seizure-related brain damage. Neurochemical Research. 1987, 12: 561-564. 10.1007/BF01000241.CrossRefPubMed Nelson SR, Olson JP: Role of early edema in the development of regional seizure-related brain damage. Neurochemical Research. 1987, 12: 561-564. 10.1007/BF01000241.CrossRefPubMed
15.
go back to reference Seitelberger F, Lassmann H, Hornykiewicz O: Some mechanism of brain edema studies in a Kainic acid model. ACTA Neurobiol Exp. 1990, 50: 263-267. Seitelberger F, Lassmann H, Hornykiewicz O: Some mechanism of brain edema studies in a Kainic acid model. ACTA Neurobiol Exp. 1990, 50: 263-267.
16.
go back to reference Kim J, Chung J, Yoon PH, Kim DI, Chung TS, Kim EJ, Jeong EK: Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: perictal diffusion-weighted imaging. Am J Neurorad. 2001, 22: 1149-1160. Kim J, Chung J, Yoon PH, Kim DI, Chung TS, Kim EJ, Jeong EK: Transient MR signal changes in patients with generalized tonicoclonic seizure or status epilepticus: perictal diffusion-weighted imaging. Am J Neurorad. 2001, 22: 1149-1160.
Metadata
Title
Cerebral edema in a patient following cytoreductive surgery and hyperthermic intraoperative intraperitoneal chemoperfusion
Authors
Rajalakshmi L Nair
Jonathan Tobias
Grant Stemmerman
Andrew M Lowy
Publication date
01-12-2006
Publisher
BioMed Central
Published in
World Journal of Surgical Oncology / Issue 1/2006
Electronic ISSN: 1477-7819
DOI
https://doi.org/10.1186/1477-7819-4-85

Other articles of this Issue 1/2006

World Journal of Surgical Oncology 1/2006 Go to the issue