Description
A 67-year-old non-smoking man with stage IV (T2N2cM0) p16-positive squamous cell carcinoma of the tongue, undergoing curative-intent hypofractionated radiation as part of a clinical trial, uneventfully received his fourth dose of weekly cisplatin 30 mg/m2. Later, he developed sudden onset of diaphoresis and experienced a near-syncope while waiting in his car outside the University Hospital. He spontaneously recovered and decided to drive home. On arriving home, he collapsed inside his doorway. He awoke on the floor, gasping for air. Emergency medical assistance transported him to a local emergency department, where he endorsed chest pain, left leg pain and shortness of breath. Vital signs on presentation showed a blood pressure of 84/65 mm Hg; his pulse was 121 bpm and pulse oximetry 93% saturation on room air. Physical examination was otherwise unremarkable. CT of the chest revealed a massive saddle pulmonary embolus and bilateral subsegmental pulmonary emboli (figure 1). The...
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