259 Erectile Dysfunction in an Adolescent with Non-Hodgkin Lymphoma Following Chemotherapy with Agents Known to Induce Cardiac Fibrosis/Myocardial Necrosis: A Case Report and Literature Review

Abstract

Adolescent and teen cancer rates are increasing, particularly thyroid, testicular, and non-Hodgkin lymphoma (NHL) cancer. Nearly 60% of pediatric cancer survivors will have late effects from treatment, including sexual dysfunction. Heart failure has been reported when using agents that induce cardiac myocardial damage. There are limited studies concerning the pathophysiology of chemotherapy-associated erectile dysfunction in adolescents. A 14 year-old male was diagnosed with stage III NHL. Prior to chemotherapy, he had normal erections. He underwent 2 years of chemotherapy, including cyclophosphamide and doxorubicin, both known to induce loss of cardiac myofilaments and fibrosis. At age 16, he observed persistent, consistent erectile dysfunction (erection hardness scale grade 3) that was associated with early detumescence. At age 24, after 8 years of persistent ED, the patient was evaluated with a biopsychosocial assessment including psychologic, pelvic floor physical therapy, neuro-genital, and penile duplex ultrasound with gray-scale evaluations. A literature review was performed using PubMed and other search engines including keywords “sexual dysfunction and chemotherapy” and similar terms.