Treating the treatment: chemotherapy-induced multi-organ toxicity

BMJ Case Rep. 2021 Mar 15;14(3):e239560. doi: 10.1136/bcr-2020-239560.

Abstract

A 40-year-old man presented to a local hospital with a 2-day history of dyspnoea having been started on adjuvant chemotherapy consisting of oxaliplatin and capecitabine for mucinous adenocarcinoma of the colon. During his admission, he develops chest pain, worsening shortness of breath, and intermittent dysarthria and disorientation. Investigations reveal severely impaired left ventricular function on echocardiogram, bilateral acute pulmonary embolisms on CT pulmonary angiogragraphy, and diffused subcortical and callosal white matter signal change and restricted diffusion consistent with a toxic leukoencephalopathy on MRI of brain. This case highlights the pivotal role of the multidisciplinary cardio-oncology approach which enabled these challenging diagnoses to be made and ensured optimal patient outcome.

Keywords: cancer - see oncology; cardiovascular medicine; colon cancer; drugs and medicines; heart failure.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antineoplastic Agents* / adverse effects
  • Contrast Media*
  • Gadolinium
  • Humans
  • Male
  • Stroke Volume
  • Ventricular Function, Left

Substances

  • Antineoplastic Agents
  • Contrast Media
  • Gadolinium