Reactions 1145 - 31 Mar 2007

Antineoplastics

Thrombosis with concomitant radiotherapy: casereport

A 25-year-old woman developed an internal carotid arterythrombosis after antineoplastic treatment and radiotherapy forHodgkin’s disease.

The woman completed eight weekly cycles of bleomycin,doxorubicin, dacarbazine and vinblastine [dosages not stated]and achieved partial remission of the disease. She completedan additional eight antineoplastic cycles; however, residualdisease was still evident. Three weeks later, she underwentinvolved radiotherapy of 30 Gy on the mediastinum up to thecarotid bifurcation and an additional 6 Gy only on themediastinum. Seven months after chemoradiotherapy, shereported two episodes of blindness in her left eye, whichlasted for a few minutes. Duplex ultrasounds of the left internalcarotid artery revealed a calcified intimal wall thickness with ahypoechogenic thrombus determining partial lumenobstruction.

The woman received aspirin and atorvastatin and, after sheexperienced another episode of blindness, she also receivedclopidogrel. At latest follow-up, she had experienced nofurther episodes of blindness and serial ultrasound of her leftinternal carotid artery revealed the vessel wall and arterialblood flow had returned to normal.

Author comment: "An endothelial dysfunction or a directactivation of the coagulation cascade by thechemoradiotherapy treatment may have resulted in theformation of a thrombus in the irradiated area."Di Nisio M, et al. Endothelial damage of the internal carotid artery afterchemoradiotherapy of the neck for a Hodgkin lymphoma. Thrombosis andHaemostasis 97: 315-316, No. 2, Feb 2007 - Italy 801070265

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Reactions 31 Mar 2007 No. 11450114-9954/10/1145-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved