Successful Multidisciplinary Management of Uterine Carcinoma Treated With Chemotherapy Under Mechanical Ventilation

We report a rare case of stage IVB endometrial carcinoma complicated by respiratory failure requiring mechanical ventilation. A 61-year-old woman with severe obesity developed bilateral pleural effusions and was admitted to the intensive care unit (ICU) for respiratory management. Because the organ failure was considered primarily tumor-related and hepatic and renal functions were preserved, weekly paclitaxel-carboplatin chemotherapy was initiated under mechanical ventilation through close multidisciplinary collaboration. The treatment was effective, leading to improvement in the pleural effusions and oxygenation, and the patient was successfully extubated and discharged after 4 months of hospitalization. Although the disease eventually progressed, the chemotherapy administered in the ICU achieved temporary tumor control and functional recovery. This case suggests that ICU-based chemotherapy for gynecologic malignancies, while nonstandard, may be feasible and beneficial in carefully selected patients with preserved organ function and potentially reversible, tumor-related organ failure.