| Popis: |
Although cetuximab-containing chemotherapies are effective treatments for unresectable advanced colorectal cancer, characteristic side effects have been reported. Here, we report a case of rectal cancer in which duodenal perforation is likely to have occurred during the administration of mFOLFOX6 plus cetuximab as first-line chemotherapy. A 55-year-old woman complained of abdominal pain for several months. She was diagnosed with advanced rectal cancer and unresectable multiple liver and lung metastases. We initiated first-line chemotherapy with mFOLFOX6 plus cetuximab, which was administered with the expectation of early tumor shrinkage and consequent reductions in her abdominal pain. After 2 courses of chemotherapy, her abdominal symptom improved. However, after 4 courses of chemotherapy, she suddenly reported severe abdominal pain and was conveyed to our department. Abdominal computed tomography revealed intraabdominal free air, which we suspected was caused by gastrointestinal perforation. Urgent laparotomy was performed. We identified the perforation at the anterior wall of the duodenal bulb, closed the perforated site, and covered it with the omentum. In general, it has been reported that chemotherapy with cetuximab regimen is associated with some adverse events such as hematotoxicity, acne-like rash and hypersensitivity reaction. This time, we experienced a rare case of duodenal perforation that might have been associated with mFOLFOX6 plus cetuximab. We suggest that bowel perforation should be considered if a patient experiences sudden abdominal pain when receiving chemotherapy. |
