Antineoplastics
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Reactions 1395 - 31 Mar 2012 S Antineoplastics Barrett’s oesophagus: case report A 15-year-old girl and a 31-year-old woman developed Barrett’s oesophagus (BE) after receiving antineoplastics [dosages, routes, durations of treatments to reaction onsets and outcomes not stated]. The girl presented with retroperitoneal neuroblastoma at 12 months of age, and received four courses of carboplatin and etoposide chemotherapy in addition to surgery. Her tumour relapsed 10 months later, with a supradiaphragmatic paravertebral extension, and she received 14 additional courses of chemotherapy as well as radiotherapy. She developed grade 2 mucositis during one course of chemotherapy, as well as grade 1–2 vomiting in all courses. Twelve years after completing treatment, she presented with haematemesis associated with untreated gastro-oesophageal reflux of 3 years’ duration, with epigastric pain and heart burn. Endoscopy revealed a salmon-coloured mucosal area of the oesophagus and grade C oesophagitis. She received omeprazole, and her symptoms resolved. Repeat endoscopy then revealed resolution of the oesophagitis; however, the pigmented mucosa persisted. Biopsy showed intestinal metaplasia with goblet cells, and she was diagnosed with BE. She continued omeprazole treatment, with endoscopic follow- up every 2 years. The woman presented with Hodgkin’s disease at 13 years of age, and received six courses of bleomycin, chlormethine, dacarbazine, doxorubicin, prednisone, procarbazine, vinblastine and vincristine [Oncovin], as well as radiotherapy. She developed grade 1 mucositis during two courses of chemotherapy, as well as grade 1–2 vomiting in all courses. Nineteen years after completing treatment, she presented with dysphagia and gastro-oesophageal reflux of 4 years’ duration, with epigastric pain and heart burn. Endoscopy revealed a distal oesophageal stricture, and she received omeprazole. One month later, repeat endoscopy revealed areas of salmon- coloured mucosa in the oesophagus. Biopsy showed intestinal metaplasia with goblet cells, and she was diagnosed with BE. She continued omeprazole treatment, with endoscopic follow-up every 2 years. Author comment: "It was possible that the asymptomatic esophageal injury by radio/chemotherapy disrupted optimal functioning of the lower esophageal sphincter and/or esophageal motility, and led to reflux and or BE at long-term follow up." Schiavetti A, et al. Barrett esophagus in long-term survivors of childhood solid tumors. Journal of Pediatric Hematology/Oncology 33: 559-61, No. 7, Oct 2011. Available from: URL: http://journals.lww.com/jpho-online/toc/2011/10000 - Italy 803068626 1 Reactions 31 Mar 2012 No. 1395 0114-9954/10/1395-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
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Transcript of Antineoplastics
Reactions 1395 - 31 Mar 2012
SAntineoplastics
Barrett’s oesophagus: case reportA 15-year-old girl and a 31-year-old woman developed
Barrett’s oesophagus (BE) after receiving antineoplastics[dosages, routes, durations of treatments to reaction onsetsand outcomes not stated].
The girl presented with retroperitoneal neuroblastoma at12 months of age, and received four courses of carboplatinand etoposide chemotherapy in addition to surgery. Hertumour relapsed 10 months later, with asupradiaphragmatic paravertebral extension, and shereceived 14 additional courses of chemotherapy as well asradiotherapy. She developed grade 2 mucositis during onecourse of chemotherapy, as well as grade 1–2 vomiting inall courses. Twelve years after completing treatment, shepresented with haematemesis associated with untreatedgastro-oesophageal reflux of 3 years’ duration, withepigastric pain and heart burn. Endoscopy revealed asalmon-coloured mucosal area of the oesophagus andgrade C oesophagitis. She received omeprazole, and hersymptoms resolved. Repeat endoscopy then revealedresolution of the oesophagitis; however, the pigmentedmucosa persisted. Biopsy showed intestinal metaplasiawith goblet cells, and she was diagnosed with BE. Shecontinued omeprazole treatment, with endoscopic follow-up every 2 years.
The woman presented with Hodgkin’s disease at13 years of age, and received six courses of bleomycin,chlormethine, dacarbazine, doxorubicin, prednisone,procarbazine, vinblastine and vincristine [Oncovin], as wellas radiotherapy. She developed grade 1 mucositis duringtwo courses of chemotherapy, as well as grade1–2 vomiting in all courses. Nineteen years aftercompleting treatment, she presented with dysphagia andgastro-oesophageal reflux of 4 years’ duration, withepigastric pain and heart burn. Endoscopy revealed a distaloesophageal stricture, and she received omeprazole. Onemonth later, repeat endoscopy revealed areas of salmon-coloured mucosa in the oesophagus. Biopsy showedintestinal metaplasia with goblet cells, and she wasdiagnosed with BE. She continued omeprazole treatment,with endoscopic follow-up every 2 years.
Author comment: "It was possible that the asymptomaticesophageal injury by radio/chemotherapy disrupted optimalfunctioning of the lower esophageal sphincter and/oresophageal motility, and led to reflux and or BE at long-termfollow up."Schiavetti A, et al. Barrett esophagus in long-term survivors of childhood solidtumors. Journal of Pediatric Hematology/Oncology 33: 559-61, No. 7, Oct 2011.Available from: URL: http://journals.lww.com/jpho-online/toc/2011/10000 -Italy 803068626
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Reactions 31 Mar 2012 No. 13950114-9954/10/1395-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
