Abstract | RATIONALE: Fluoropyrimidine-induced cardiotoxicity is a rare but potentially serious toxicity. The most common symptom is anginal chest pain. PATIENT CONCERNS: DIAGNOSIS: A computed tomography scan showed a 9.3 × 4.5-cm predominantly hypodense lesion within the left lobe of the liver and thickening of the rectum. Liver biopsy showed moderately differentiated adenocarcinoma with necrosis involving the liver parenchyma, and immunohistochemistry for mismatch repair proteins indicated that the tumor was positive for MutL Homolog 1, MutS Homolog 2, MutS Homolog 6, and Protein Homolog 2. Rectal biopsy indicated moderately differentiated adenocarcinoma. INTERVENTIONS: OUTCOMES: LESSONS: Although the mechanism of fluoropyrimidine-induced cardiotoxicity is still uncertain, our case provides clinical evidence that cardiotoxicity could be a dose-related complication. Reducing the dose of fluoropyrimidine should be considered as a strategy after fluoropyrimidine-induced cardiotoxicity. However, this must be discussed with a multidisciplinary team including oncologists and cardiologists. Close monitoring of serial biomarkers and echocardiography are necessary for early diagnosis of cardiotoxicity.
|
Authors | Tao Peng, Yulu Ouyang, Kanger Tong |
Journal | Medicine
(Medicine (Baltimore))
Vol. 98
Issue 2
Pg. e14057
(Jan 2019)
ISSN: 1536-5964 [Electronic] United States |
PMID | 30633206
(Publication Type: Case Reports, Journal Article)
|
Chemical References |
- Antimetabolites, Antineoplastic
- Capecitabine
- Fluorouracil
|
Topics |
- Adenocarcinoma
(drug therapy, pathology)
- Adult
- Antimetabolites, Antineoplastic
(administration & dosage, toxicity)
- Capecitabine
(administration & dosage)
- Cardiotoxicity
(etiology)
- Combined Modality Therapy
- Female
- Fluorouracil
(administration & dosage, toxicity)
- Humans
- Liver Neoplasms
(drug therapy, secondary)
- Rectal Neoplasms
(drug therapy, pathology)
|