Atypical reversible leucoencephalopathy syndrome after bevacizumab/folfox regimen for metastatic colon cancer.

Narimane Salmi,Hassan Errihani,Hind Mrabti,Ibrahim Elghissassi,Khadija Bellahammou,Asmaa Lakhdissi

doi:10.1155/2014/391256

Narimane Salmi, Hassan Errihani + Show 4 more

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https://doi.org/10.1155/2014/391256

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Abstract

We are reporting a case of multifocal reversible leucoencephalopathy syndrome induced by chemotherapy based on Folfox-Bevacizumab regimen. A 44-year-old female, with no history of hypertension, received a chemotherapy based on Folfox-Bevacizumab for her metastatic colon cancer (5 FU: 325 mg/m2 d1 by intravenous infusion, Oxaliplatin 80 mg/m2 d1, and Bevacizumab: 7.5 mg/Kg d1). During the fourth cure, she presented delirium, seizures, and visual disturbances. The computed tomography (CT) of the brain showed hypodense lesions of the white matter of frontal, parietal, and occipital lobes, which were bilateral and symmetrical. The clinical table was reversible under symptomatic treatment.

Highlights

Leucoencephalopathy postchemotherapy is a very rare complication that affects the central nervous system
Posterior reversible leucoencephalopathy syndrome (PRLS) is the most described in the literature [1]; it is characterized by an impairment of the white matter of the posterior cerebral hemispheres
We describe an unusual case of diffuse leucoencephalopathy syndrome after chemotherapy based on Folfox-Bevacizumab (5 FU: 325 mg/m2 d1 by intravenous infusion, Oxaliplatin 80 mg/m2 d1, and Bevacizumab: 7.5 mg/Kg d1) affecting the central nervous system

Summary

Introduction

Leucoencephalopathy postchemotherapy is a very rare complication that affects the central nervous system. Posterior reversible leucoencephalopathy syndrome (PRLS) is the most described in the literature [1]; it is characterized by an impairment of the white matter of the posterior cerebral hemispheres. In some cases, this syndrome can affect the anterior hemispheres, gray matter, brainstem, and basal ganglia [2,3,4]. We describe an unusual case of diffuse leucoencephalopathy syndrome after chemotherapy based on Folfox-Bevacizumab (5 FU: 325 mg/m2 d1 by intravenous infusion, Oxaliplatin 80 mg/m2 d1, and Bevacizumab: 7.5 mg/Kg d1) affecting the central nervous system

Case Presentation

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Discussion