Hepatic portal venous gas in a patient with metastatic non-small cell lung cancer on bevacizumab therapy: a case report and review of the literature.

Abstract:

BACKGROUND:The presence of hepatic portal venous gas (HPVG) is a rare finding. It is most commonly caused by bowel necrosis and typically carries a grave prognosis. Bevacizumab has emerged as an effective standard therapy in the frontline management of advanced non-small cell lung cancer (NSCLC). Although bevacizumab is associated with gastrointestinal perforation, it has not been shown to cause HPVG. CASE:A 75-year-old man, diagnosed with metastatic NSCLC, was treated with palliative chemotherapy consisting of paclitaxel, carboplatin, and bevacizumab for six cycles. He continued on maintenance bevacizumab after that for a total of six doses, given every 3 weeks, with continued stable disease. During a surveillance CT scan 4 weeks after the last dose of bevacizumab, HPVG was shown. CONCLUSION:This is the first case of HPVG associated with bevacizumab therapy in a patient with metastatic NSCLC. The HPVG may have been an early warning sign of impending bowel perforation, and bevacizumab was immediately discontinued, with HPVG completely resolving on follow-up CT scan 2 weeks later. We recommend that bevacizumab therapy be immediately and permanently discontinued whenever HPVG is observed, as this may help avoid a potentially catastrophic outcome.

authors

Ortega J,Hayes JM,Antonia S

doi

10.1007/s00280-009-1104-8

subject

Has Abstract

pub_date

2009-12-01 00:00:00

pages

187-90

issue

1

eissn

0344-5704

issn

1432-0843

journal_volume

65

pub_type

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