Angioedema in a patient with neuroendocrine tumour

Description

We present a case of a man aged 60 years, who was transferred to intensive care unit (ICU) due to labile blood pressure and a failed extubation trial after right carotid endarterectomy. His medical history was remarkable for symptomatic right carotid artery disease and recently diagnosed asymptomatic large cell neuroendocrine tumours (LCNETs) of the rectum with liver metastasis (figure 1A, B), currently on chemotherapy. In the recovery room, he had stridor with hypoxia after extubation and was noticed to have marked swelling of lips, tongue and eyelids (figure 2A). He was given epinephrine and steroids and subsequently reintubated with some difficulty. During ICU stay, he was given steroids, racemic epinephrine nebulisers and H1 blockers. The next day, he had improvement of the swelling and was extubated successfully. ENT evaluation showed residual laryngeal swelling with surrounding soft tissue swelling. CT scan of the head...

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