International Journal For Multidisciplinary Research

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Anesthetic Challenges in a Patient with Nodular Sclerosing Classical Hodgkin’s Lymphoma complicated by Cervical Metastasis and SVC Syndrome: A Case Report

Author(s) Alyanna Patrice L. Arceo, M.D., Mark Andrew B. Cruz, M.D.
Country Philippines
Abstract This case presents the anesthetic complexities involved in managing a patient with nodular sclerosing classical Hodgkin’s Lymphoma, who presented with severe airway compromise, limited neck mobility due to C7 vertebra involvement, and superior vena cava syndrome. The patient, with an extensive anterior neck mass extending into the mediastinum, post-auricular, and axillary areas, exhibited symptoms such as dyspnea, orthopnea, facial swelling, and upper extremity edema, complicating traditional airway management techniques. Faced with these challenges, the team anticipated significant difficulty with ventilation, direct laryngoscopy, and invasive airway access. To address the airway obstruction effectively before initiating radiotherapy, the anesthesiologists employed awake nasotracheal intubation using a fiberoptic scope with minimal sedation using Remifentanil. This approach successfully secured the airway and facilitated an extended tracheostomy. The patient tolerated the procedure well and was eventually discharged. This case underscores the critical role of fiberoptic intubation in managing complex airway scenarios, particularly in patients with complex malignancies and associated complications.
Keywords Classical Hodgkin Lymphoma, Difficult airway, Limited neck mobility, SVC syndrome
Field Medical / Pharmacy
Published In Volume 6, Issue 6, November-December 2024
Published On 2024-11-16
Cite This Anesthetic Challenges in a Patient with Nodular Sclerosing Classical Hodgkin’s Lymphoma complicated by Cervical Metastasis and SVC Syndrome: A Case Report - Alyanna Patrice L. Arceo, M.D., Mark Andrew B. Cruz, M.D. - IJFMR Volume 6, Issue 6, November-December 2024. DOI 10.36948/ijfmr.2024.v06i06.30616
DOI https://doi.org/10.36948/ijfmr.2024.v06i06.30616
Short DOI https://doi.org/g8rd3b
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