Anaesthetic Management of Excision of a Single Huge Thoracoabdominal Metastatic Deposit Involving Liver and Right Lung

Clear cell ovarian carcinoma (CCC) is a rare type of ovarian cancer. Recurrence at multiple sites is the most common pattern in CCC, occurring in 64.4% of cases, with widespread peritoneal involvement being the most typical presentation. The liver and lungs are the sites for distant organ metastasis. Treatment involves aggressive cytoreductive surgery and platinum-based chemotherapy. Here, we describe the management of a 45-year-old female with clear cell carcinoma of the ovary presenting with a huge thoracoabdominal metastatic mass from a primary ovarian tumour, requiring extensive staging laparotomy with right thoracotomy. Due to extensive surgical resection, significant blood transfusion and one-lung ventilation for a longer period were needed. Here, we attempt to identify anaesthetic challenges posed due to an extensive tumour extending from the abdomen to the thoracic cavity.