What happened, in summary

A 67-year-old man with stomach cancer received chemotherapy before undergoing subtotal gastrectomy with D2 lymph-node dissection. Nearly a year after surgery, he developed jaundice. Investigations showed recurrent cancer involving the surgical connection, the peritoneum and lymph nodes near the liver, with bile-duct infiltration causing mechanical jaundice. A drainage procedure was performed, and he restarted chemotherapy. The peritoneal involvement was consistent with metastatic, Stage IV disease.

During treatment, a fragment of his implanted chemotherapy-port catheter broke off and traveled to a branch of the right pulmonary artery. About a week after another chemotherapy dose, he developed persistent cough, weakness, nausea and chest discomfort. Imaging identified the catheter fragment in the pulmonary artery. Because endovascular removal was not technically available, surgeons performed a thoracotomy and removed the fragment directly from the artery. His immediate recovery from that operation was uncomplicated.

He was then transferred back to oncology for management of the biliary drainage and the remaining vascular port. Despite these interventions, the gastric cancer continued to advance. He died two months later as the gastric cancer continued to advance.