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Hepatic portal venous gas in a patient with metastatic non-small cell lung cancer on bevacizumab therapy: a case report and review of the literature
- Source :
- Cancer Chemotherapy and Pharmacology. 65:187-190
- Publication Year :
- 2009
- Publisher :
- Springer Science and Business Media LLC, 2009.
-
Abstract
- The presence of hepatic portal venous gas (HPVG) is a rare finding. It is most commonly caused by bowel necrosis and typically carries a grave prognosis. Bevacizumab has emerged as an effective standard therapy in the frontline management of advanced non-small cell lung cancer (NSCLC). Although bevacizumab is associated with gastrointestinal perforation, it has not been shown to cause HPVG. A 75-year-old man, diagnosed with metastatic NSCLC, was treated with palliative chemotherapy consisting of paclitaxel, carboplatin, and bevacizumab for six cycles. He continued on maintenance bevacizumab after that for a total of six doses, given every 3 weeks, with continued stable disease. During a surveillance CT scan 4 weeks after the last dose of bevacizumab, HPVG was shown. This is the first case of HPVG associated with bevacizumab therapy in a patient with metastatic NSCLC. The HPVG may have been an early warning sign of impending bowel perforation, and bevacizumab was immediately discontinued, with HPVG completely resolving on follow-up CT scan 2 weeks later. We recommend that bevacizumab therapy be immediately and permanently discontinued whenever HPVG is observed, as this may help avoid a potentially catastrophic outcome.
- Subjects :
- Male
Cancer Research
medicine.medical_specialty
Lung Neoplasms
genetic structures
Bevacizumab
Angiogenesis Inhibitors
Antibodies, Monoclonal, Humanized
Toxicology
Metastasis
chemistry.chemical_compound
Gastrointestinal perforation
Carcinoma, Non-Small-Cell Lung
Embolism, Air
Humans
Medicine
Pharmacology (medical)
Neoplasm Metastasis
Lung cancer
Aged
Pharmacology
Portal Vein
business.industry
Respiratory disease
Antibodies, Monoclonal
Cancer
medicine.disease
eye diseases
Carboplatin
Surgery
Oncology
chemistry
Paclitaxel
Intestinal Perforation
sense organs
business
Follow-Up Studies
medicine.drug
Subjects
Details
- ISSN :
- 14320843 and 03445704
- Volume :
- 65
- Database :
- OpenAIRE
- Journal :
- Cancer Chemotherapy and Pharmacology
- Accession number :
- edsair.doi.dedup.....c52479ec081d51a6d0e49a22ad3751ed