title: Sudden onset of paraplegia after total hip replacement surgery in a patient with hepatocellular carcinoma--a case report.
abstract: Postoperative paraplegia is a major complication, of which the pathogenesis is usually multifactorial. This report is to discuss the case of a 36-year-old male patient who, after total hip replacement (THR), right, sustained a sudden-onset postoperative paraplegia. On subsequent examination, it was discovered that the patient had multiple vertebral metastases from hepatocellular carcinoma (HCC) resulting in thecal sac compression at L1 and S1 levels. This instance of distal spinal metastasis from HCC, with initial presentation of a sudden onset of paraplegia immediately after THR surgery, is worth reporting because of its being a rare occurrence and traumatizing effects on the patient, family members, and the surgical team. More importantly, we bring forth this case in order to advance an opinion concerning prevention of this devastating complication. Hence, we discuss the contributory factors and the appropriate perioperative survey and management relevant to cancer patients who are to undergo a non-cancer surgery.
authors.affiliation: Department of Anesthesiology, Chang Gung Memorial Hospital, Niao Shung Hsiang, Kaohsiung, Taiwan, ROC.
authors.forename: Kun-Chen
authors.initials: KC
authors.lastname: Lin
authors.forename: Yi-Shen
authors.initials: YS
authors.lastname: Chen
authors.forename: Yu-San
authors.initials: YS
authors.lastname: Liao
authors.forename: Ping-Heng
authors.initials: PH
authors.lastname: Tan
authors.forename: Tai-I
authors.initials: TI
authors.lastname: Chen
authors.forename: An-Kuo
authors.initials: AK
authors.lastname: Chou
mesh_terms: D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D006801:Humans; D007108:Immune Tolerance; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D010264:Paraplegia / Q000209:etiology*; D011183:Postoperative Complications / Q000209:etiology*