Diagnosis of colo-rectal cancer revealed by haemorrhagic complication of intraarterial thrombolysis

Schellhammer, F.; Pourhassan, S.; Topp, Sascha; Fürst, G.

doi:10.1024/0301-1526.36.2.143

Cited by 2 publications

(3 citation statements)

References 12 publications

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“…One-hundred and thirty-five cases of colonic cancers during thrombolytic, anticoagulation, or antiaggregant therapy have been reported in five studies (Table 2). Of the reported cases, 83 patients were diagnosed with the early-stage colonic cancer 5,6,[9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

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Diagnosis of proximal colonic cancer due to hemorrhagic complication of thrombolytic therapy on myocardial infarction

Alanís-Naranjo,

Muñoz-Pérez,

Cáceres-Castro

2023

HGMX

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The incidence of major bleeding in patients who receive thrombolytic therapy has been reported at 3.6%, with gastrointestinal bleeding the most common site followed by vascular access bleeds. The most typical cause of gastrointestinal bleeding is peptic ulcer disease. In the literature, few reports of thrombolytic therapy reveal undiagnosed colonic carcinoma. An 82-year-old man presented an acute posteroinferior myocardial infarction; he denied no gastrointestinal symptoms before hospital admission. Tenecteplase IV was administered with an improved clinical condition and an electrocardiogram showed reperfusion criteria. Approximately ten hours later, he experienced hematochezia; blood tests were relevant due to a descent of hemoglobin. A colonoscopy with biopsy revealed adenocarcinoma in the ascending colon. After stabilization, right hemicolectomy confirmed the cecum's invasive adenocarcinoma (T4aN0M0, stage IIB). The tumor was successfully removed, and chemotherapy was initiated. Thrombolytic therapy makes occult bleeding from colonic cancers obvious. Awareness of this fact may lead to earlier diagnosis of colonic cancers in asymptomatic patients and an increased likelihood of survival. Patients who develop gastrointestinal bleeding after thrombolytic therapy should receive a complete workup of the gastrointestinal tract to exclude serious but potentially curable diseases.

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Section: Discussionmentioning

confidence: 99%

“…Peptic ulcer disease is the most typical cause of gastrointestinal bleeding after thrombolytic therapy 5 . In the literature, few reports of thrombolytic therapy reveal undiagnosed colonic carcinoma 5,6 . We report the case of a colonic adenocarcinoma diagnosed following thrombolytic therapy on myocardial infarction.…”

Section: Introductionmentioning

confidence: 99%

Diagnosis of proximal colonic cancer due to hemorrhagic complication of thrombolytic therapy on myocardial infarction

Alanís-Naranjo,

Muñoz-Pérez,

Cáceres-Castro

2023

HGMX

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“…Therefore, earlier post-thrombolysis non-invasive investigations such as systemic CT scans to search for bleeding risks might have at least prevented the delayed gastrointestinal bleeding. Apart from urgent stroke thrombolysis, a patient with an unrecognized tumor who received local thrombectomy and thrombolysis with tPA for acute limb artery ischemia developed rectal bleeding, leading to the diagnosis of colorectal can-cer [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Intravenous Tissue Plasminogen Activator for an Ischemic Stroke with Occult Double Primary Cancer

et al. 2014

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Background: In patients with advanced-stage cancer, systemic thrombolysis with tissue plasminogen activator (tPA) for hyperacute ischemic stroke is not strictly off-label, but it is at higher risk of complications (including bleeding). Case Report: A 71-year-old male with unrecognizable malignancy developed a hemispheric ischemic stroke and received intravenous tPA within 4.5 h of onset, followed by anticoagulation treatment after 24 h of thrombolysis. Two days later, the patient had tarry stool and progressive anemia, receiving a blood transfusion. The systemic workup documented the presence of double primary cancers with advanced stage gastric and rectal cancers, and the patient subsequently received palliative care. The outcome at 3 months was a modified Rankin Scale of 5, and the patient died 6 months after the stroke. Discussion: Although systemic thrombolysis with tPA for ischemic stroke in patients with advanced-stage cancer may be performed relatively safely, optimal post-thrombolysis management is important to prevent the complications.

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Diagnosis of colo-rectal cancer revealed by haemorrhagic complication of intraarterial thrombolysis

Cited by 2 publications

References 12 publications

Diagnosis of proximal colonic cancer due to hemorrhagic complication of thrombolytic therapy on myocardial infarction

Diagnosis of proximal colonic cancer due to hemorrhagic complication of thrombolytic therapy on myocardial infarction

Intravenous Tissue Plasminogen Activator for an Ischemic Stroke with Occult Double Primary Cancer

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