Pneumatosis intestinalis after etoposide-based chemotherapy in a patient with metastatic small cell lung cancer: successful conservative management of a rare condition

• Autor(a) principal: Faria,Luiza Dib Batista Bugiato
• Data de Publicação: 2016
• Outros Autores: Anjos,Carlos Henrique dos, Fernandes,Gustavo dos Santos, Carvalho,Igor Fernando da Silva
• Tipo de documento: Relatório
• Idioma: eng
• Título da fonte: Einstein (São Paulo)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082016000300420
• topic: Pneumatosis cystoids intestinalis/chemically induced; Etoposide/administration & dosage; Etoposide/adverse effects; Carboplatin/administration & dosage; Carboplatin/adverse effects; Lung neoplasms/drug therapy; Neoplasm metastasis; Case reports

ABSTRACT A 69-year-old male patient, smoker, was diagnosed with small cell lung cancer metastatic to lung, liver and central nervous system. He received chemotherapy with carboplatin AUC 5 on day 1 and etoposide 100mg/m2 on days 1, 2 and 3. During the first cycle, the patient presented with febrile neutropenia and abdominal distension. Chest, abdomen and pelvis computed tomography scan was performed and detected gas dissecting the wall of sigmoid colon extending to the mesosigmoid. Patient had no abdominal pain, nausea, vomiting, and on physical examination he had no peritoneal irritation, tachycardia or hemodynamic instability compatible with perforation or acute abdomen. Therefore, the radiological finding was interpreted as pneumatosis intestinalis caused by chemotherapy with etoposide. Pneumatosis resolved after continuous oxygen therapy. The second cycle was administered after a complete resolution of the clinical condition and etoposide dose was reduced by 30%. The patient experienced a remarkable evolution.