Reactions 1428 - 17 Nov 2012

SAntineoplastics

Laryngeal nerve injury and hoarseness: casereport

A 34-year-old woman developed a laryngeal nerve injurycomplicated by hoarseness following chemotherapy formetastatic colon cancer [not all routes and frequenciesstated].

The woman, who had adenocarcinoma of the sigmoidcolon, was initially treated with FOLFOX-4 between Mayand August 2008. Due to disease progression and thedevelopment of liver metastases, she began receivingsecond-line chemotherapy with weekly cetuximab[Erbitux] and biweekly FOLFIRI in October 2009.Chemotherapy was delivered using an indwelling port-Acatheter through the left subclavian vein. The regimenconsisted of cetuximab 400 mg/m2 loading dose, followedby a weekly maintenance dose of 250 mg/m2, irinotecan180 mg/m2 IV infusion for 90 min on day 1, fluorouracil400 mg/m2 bolus on day 1, folinic acid [leucovorin]200 mg/m2 and fluorouracil 2400 mg/m2 46h infusion. InApril 2010, after receiving 23 doses of cetuximab and11 doses of FOLFIRI, she presented with hoarseness andmild retrosternal chest pain. Otolaryngology showed aparalysed left vocal cord, and a chest CT revealed extensivefluid infiltration into the superior and anteriormediastinum. Antegrade venography was performed, andcontast medium retention was seen in the superiormediastinum. A laryngeal nerve injury complicated byhoarseness was confirmed. The hoarseness resolvedspontaneously one week after chemotherapy. The port-Acatheter was removed, and she made a complete recovery.

Author comment: "Hoarseness could be a rarecomplication of port-A catheter malposition and extravasationof chemotherapeutic drugs. . . The clinical symptom ofhoarseness occurred after chemotherapeutic agent infusion;therefore, chemotherapeutic agent-related transient recurrentlaryngeal nerve injury complicated by hoarseness wasconfirmed."Wang JC, et al. Hoarseness: an unusual complication of port-A catheterperforation. Onkologie 35: 122-4, No. 3, Jan 2012 - Taiwan 803079771

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Reactions 17 Nov 2012 No. 14280114-9954/10/1428-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved