Yanagisawa A et al. (2017), Crizotinib-induced Rectal Perforation with Absc...

ECB-ART-50736

Intern Med 2017 Dec 01;5623:3211-3213. doi: 10.2169/internalmedicine.8214-16.

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Crizotinib-induced Rectal Perforation with Abscess.

Yanagisawa A , Hayama N , Amano H , Nakamura M , Hirano S , Nakamura S , Tabeta H .

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An 86-year-old Japanese man was diagnosed with stage IV lung adenocarcinoma. The patient was treated with crizotinib after echinoderm microtubule-associated protein-like 4 (EML4)-anaplastic lymphoma kinase (ALK) rearrangement was detected from his pleural effusion. He subsequently developed abdominal pain and rebound tenderness in the right lower abdomen. Contrast-enhanced abdominal CT showed a low-density area in the abdominal cavity. The size of the abscess was decreased by drainage and the administration of antibiotics. Fistulography revealed a fistula from the rectum to the abscess, and a diagnosis of lower intestinal tract perforation with abscess formation was made. Crizotinib was discontinued and treatment with alectinib was initiated. The patient remains under treatment as an outpatient at our department without adverse effects.

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References [+] :

Cheon, Bowel perforation after erlotinib treatment in a patient with non-small cell lung cancer. 2011, Pubmed

	Figure 1. Chest CT showing consolidation in the right S2 segment and pleural effusion.
	Figure 2. A: Chest X-ray before crizotinib therapy showed consolidation and ground glass opacity in the right midlung. B: Chest X-ray showed a reduction in tumor size on day 6.
	Figure 3. Abdominal contrast enhanced CT demonstrated a fluid collection indicating an abscess in the lower quadrant.
	Figure 4. Fistulography showed a fistula from the rectum to the abscess.