Bilateral adrenal haematoma complicated by adrenal insufficiency in a patient treated with bevacizumab

被引:1
|
作者
Smolenschi, Cristina [1 ]
Tazdait, Melodie [1 ]
Kuhn, Emanuelle [2 ]
Boige, Valerie [1 ]
机构
[1] Inst Gustave Roussy, Dept Med Oncol, Villejuif, Ile De France, France
[2] Hosp Bicetre, Endocrine Dept, Le Kremlin Bicetre, Ile De France, France
关键词
colon cancer; adrenal disorders; METASTATIC COLORECTAL-CANCER; 1ST-LINE TREATMENT; RAS MUTATIONS; CHEMOTHERAPY;
D O I
10.1136/bcr-2020-239689
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bevacizumab (bev) significantly improves outcomes of patients with metastatic colorectal cancer (mCRC). However, the addition of bev to concurrent chemotherapy significantly increased the risk of haemorrhage. We describe the case of a patient with mCRC who presented with acute diffuse abdominal pain following four cycles of bev-containing systemic chemotherapy. A CT revealed the appearance of bilateral adrenal enlargement suggestive of acute adrenal haematoma. Blood test results showed a dramatic decrease in cortisol level and highly elevated Adrenocorticotropic Hormone (ACTH) level suggesting an adrenal insufficiency. After differential diagnosis, we hypothesised that bev may have contributed to the development of a bilateral adrenal haematoma complicated by adrenal insufficiency. Bev was immediately withdrawn and the patient was subsequently treated with hydrocortisone substitution with favourable outcome. This case highlights for the first time the possibility of adrenal bleeding with bev-containing chemotherapy.
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页数:5
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