Snapshot quiz 11/8

Published: 05/30/2012

Authors: Ni Choileain N

This patient has advanced colonic adenocarcinoma with cutaneous metastases. The diagnosis was proven histologically following biopsy. Management was instituted with isolated limb perfusion, whereby melphelan and actinomycin D were infused into the femoral vessels of the affected limb, which was isolated from the systemic circulation using a pneumatic tourniquet. The infusate was circulated for 30 min, after which the limb was flushed with Hartmann’s solution and the effluent discarded. The patient achieved a modest response to treatment with regression of many of the tumour deposits below the knee, providing symptom relief and local control.