An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate

Neuroendocrine Carcinoma of the Prostate (NECP) is rare and only few cases have been reported, constituting less than 0.5% of prostatic malignancies. We report a rare case of large bowel obstruction from NECP posing a further challenge in management due to resistant hypokalaemia. A 70-year-old man p...

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Main Authors: Umasankar Mathuram Thiyagarajan, A. Ponnuswamy, A. Bagul, A. Gupta
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Surgery
Online Access:http://dx.doi.org/10.1155/2017/2394365
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author Umasankar Mathuram Thiyagarajan
A. Ponnuswamy
A. Bagul
A. Gupta
author_facet Umasankar Mathuram Thiyagarajan
A. Ponnuswamy
A. Bagul
A. Gupta
author_sort Umasankar Mathuram Thiyagarajan
collection DOAJ
description Neuroendocrine Carcinoma of the Prostate (NECP) is rare and only few cases have been reported, constituting less than 0.5% of prostatic malignancies. We report a rare case of large bowel obstruction from NECP posing a further challenge in management due to resistant hypokalaemia. A 70-year-old man presented with clinical signs of large bowel obstruction who was known to have prostatic carcinoma three years ago, treated initially with hormone therapy then chemoradiation. The blood profile showed a severe hypokalaemia and CT scan revealed liver and lung metastases apart from confirming large bowel obstruction from local invasion of NECP. Severe hypokalaemia was believed to be caused by paraneoplastic syndrome from tumor burden or by recent administration of Etoposide. Intensive potassium correction through a central venous access in maximal doses of 150 mmol/24 hours under cardiac monitoring finally raised serum potassium to 3.8 mmol/L. This safe period allowed us to perform a trephine colostomy at the left iliac fossa. The postoperative period was relatively uneventful. This first case report is presenting a rare cause of large bowel obstruction from a neuroendocrine carcinoma of prostate and highlights the importance of an early, intensive correction of electrolytes in patients with large tumor burden from NECP.
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spelling doaj-art-dbe550f1c7e848f7a0db72b88f4c1a2f2025-02-03T05:58:57ZengWileyCase Reports in Surgery2090-69002090-69192017-01-01201710.1155/2017/23943652394365An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the ProstateUmasankar Mathuram Thiyagarajan0A. Ponnuswamy1A. Bagul2A. Gupta3Department of Hepatobiliary Surgery, Royal Free Hospital, Pond Street, London NW3 2QG, UKDepartment of Paediatrics, Eastbourne District General Hospital, Eastbourne BN21 2UD, UKDepartment of Transplantation, Leicester General Hospital, Leicester LE5 4PW, UKDepartment of General Surgery, St Helier Hospital, Carshalton SM5 1AA, UKNeuroendocrine Carcinoma of the Prostate (NECP) is rare and only few cases have been reported, constituting less than 0.5% of prostatic malignancies. We report a rare case of large bowel obstruction from NECP posing a further challenge in management due to resistant hypokalaemia. A 70-year-old man presented with clinical signs of large bowel obstruction who was known to have prostatic carcinoma three years ago, treated initially with hormone therapy then chemoradiation. The blood profile showed a severe hypokalaemia and CT scan revealed liver and lung metastases apart from confirming large bowel obstruction from local invasion of NECP. Severe hypokalaemia was believed to be caused by paraneoplastic syndrome from tumor burden or by recent administration of Etoposide. Intensive potassium correction through a central venous access in maximal doses of 150 mmol/24 hours under cardiac monitoring finally raised serum potassium to 3.8 mmol/L. This safe period allowed us to perform a trephine colostomy at the left iliac fossa. The postoperative period was relatively uneventful. This first case report is presenting a rare cause of large bowel obstruction from a neuroendocrine carcinoma of prostate and highlights the importance of an early, intensive correction of electrolytes in patients with large tumor burden from NECP.http://dx.doi.org/10.1155/2017/2394365
spellingShingle Umasankar Mathuram Thiyagarajan
A. Ponnuswamy
A. Bagul
A. Gupta
An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate
Case Reports in Surgery
title An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate
title_full An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate
title_fullStr An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate
title_full_unstemmed An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate
title_short An Unusual Case of Resistant Hypokalaemia in a Patient with Large Bowel Obstruction Secondary to Neuroendocrine Carcinoma of the Prostate
title_sort unusual case of resistant hypokalaemia in a patient with large bowel obstruction secondary to neuroendocrine carcinoma of the prostate
url http://dx.doi.org/10.1155/2017/2394365
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