Antineoplastics
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Reactions 1304 - 5 Jun 2010 S Antineoplastics Leucopenia, contributing to cystic ovaries and uterine perforation: case report During chemotherapy for choriocarcinoma, a 25-year- old woman developed leucopenia [time to reaction onset not stated], which contributed to the development of cystic ovaries and uterine perforation The primagravida primapara woman presented with persistent uterine bleeding 3 weeks after spontaneous delivery. After curettage, choriocarcinoma with multiple bilateral lung metastases was diagnosed. She underwent urgent uterine artery embolisation, followed by chemotherapy according to the EMA/CO regimen (etoposide, methotrexate, dactinomycin, cyclophosphamide and vincristine) [dosages not stated]. She was hospitalised with septic shock 10 days later, and an abdominal CT scan revealed bilateral voluminous cystic ovaries and a right-sided uterus perforation. Tumour- associated necrosis, post-traumatic lesion through curettage, ischaemia following embolisation and chemotherapy-induced leucopenia were considered causative factors. The woman started receiving broad-spectrum antibiotic therapy (vancomycin, meropenem and clindamycin) without success. Urgent adnex-sparing hysterectomy was then performed, but cytology of abdominal lavage revealed Clostridium perfringens; antibiotic therapy was continued with clindamycin and meropenem. However, inflammatory parameters persisted and she underwent surgical revision with extended lavage; both adnexa were considered foci of inflammation and removed. The woman’s postoperative course was positive, and chemotherapy was resumed as scheduled with one cycle every 2 weeks. Her β-hCG level normalised after a total of five therapy cycles, no new tumour foci were evident and her lung metastases regressed. Another two therapy cycles were performed [outcome of leucopenia not stated]. Cancer had not recurred 9 months after diagnosis. Sohnchen N, et al. Up to date of the treatment of patients with choriocarcinoma: A case report. Journal fur Gynakologische Endokrinologie 20: 6-11, No. 1, 2010 [German] - Switzerland 803018649 1 Reactions 5 Jun 2010 No. 1304 0114-9954/10/1304-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
Transcript of Antineoplastics
Reactions 1304 - 5 Jun 2010
SAntineoplastics
Leucopenia, contributing to cystic ovaries anduterine perforation: case report
During chemotherapy for choriocarcinoma, a 25-year-old woman developed leucopenia [time to reaction onsetnot stated], which contributed to the development of cysticovaries and uterine perforation
The primagravida primapara woman presented withpersistent uterine bleeding 3 weeks after spontaneousdelivery. After curettage, choriocarcinoma with multiplebilateral lung metastases was diagnosed. She underwenturgent uterine artery embolisation, followed bychemotherapy according to the EMA/CO regimen(etoposide, methotrexate, dactinomycin,cyclophosphamide and vincristine) [dosages not stated].She was hospitalised with septic shock 10 days later, andan abdominal CT scan revealed bilateral voluminous cysticovaries and a right-sided uterus perforation. Tumour-associated necrosis, post-traumatic lesion throughcurettage, ischaemia following embolisation andchemotherapy-induced leucopenia were consideredcausative factors.
The woman started receiving broad-spectrum antibiotictherapy (vancomycin, meropenem and clindamycin)without success. Urgent adnex-sparing hysterectomy wasthen performed, but cytology of abdominal lavage revealedClostridium perfringens; antibiotic therapy was continuedwith clindamycin and meropenem. However, inflammatoryparameters persisted and she underwent surgical revisionwith extended lavage; both adnexa were considered foci ofinflammation and removed.
The woman’s postoperative course was positive, andchemotherapy was resumed as scheduled with one cycleevery 2 weeks. Her β-hCG level normalised after a total offive therapy cycles, no new tumour foci were evident andher lung metastases regressed. Another two therapy cycleswere performed [outcome of leucopenia not stated].Cancer had not recurred 9 months after diagnosis.Sohnchen N, et al. Up to date of the treatment of patients with choriocarcinoma: Acase report. Journal fur Gynakologische Endokrinologie 20: 6-11, No. 1, 2010[German] - Switzerland 803018649
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Reactions 5 Jun 2010 No. 13040114-9954/10/1304-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
