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A 53-year-old man with long-standing hypothyroidism developed progressive upper-abdominal pain and repeated vomiting. Endoscopy found a large ulcerating mass that completely blocked the gastric outlet, and biopsy confirmed gastric adenocarcinoma. Staging CT showed that the cancer was considered surgically resectable.
Before major surgery, however, his severe hypothyroidism created an additional safety concern. Because the obstruction prevented reliable absorption of his usual oral levothyroxine and injectable treatment was not immediately available, the medical team tried alternative thyroid-hormone delivery, including rectal levothyroxine enemas. Higher-dose rectal treatment eventually restored his thyroid hormone levels sufficiently for surgery.
On hospital day 19, he underwent subtotal gastrectomy with Roux-en-Y gastrojejunostomy and lymph-node dissection. Intravenous thyroid hormone became available for the immediate postoperative period.
This is a lay summary of an account first published by PMC / PubMed Central. Read the original in full
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These are lay summaries of published cancer stories, for information only. No two cancers behave the same way, and nothing here predicts your own diagnosis or replaces advice from your oncology team. Read the full disclaimer