内容紹介
A Case of Pneumatosis Cystoides Intestinalis Secondary to Gefitinib Therapy for Lung Adenocarcinoma
Summary
Pneumatosis cystoides intestinalis(PCI)is a relatively rare condition, characterized by subserosal or submucosal air within the bowel wall. Herein, we report a rare case of PCI secondary to treatment with an epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI). A 71-year-old man, who had received gefitinib therapy for 2 years and 5 months for lung adenocarcinoma with metastases to the bones and brain, presented with abdominal pain, diarrhea, and vomiting. Computed tomography of the abdomen revealed intramural air in the small bowel, free air in the abdomen, and moderate ascites. A diagnosis of PCI was made, and the patient was managed conservatively by discontinuing gefitinib treatment, because his vital signs were stable and there was no sign of peritonitis. The patient's symptoms gradually improved, and follow-up CT after 1 week revealed that the initial findings had almost completely resolved. Clinicians should note that treatment with gefitinib might cause PCI.
要旨
症例は71歳,男性。骨転移,脳転移を伴う肺腺癌に対して,2年5か月前よりgefitinib(250 mg/日)を連日投与され,安定(stable disease: SD)を維持中に腹痛,下痢,嘔吐を発症した。腹部骨盤造影CT検査を施行すると小腸壁内ガス像,腹腔内遊離ガス像,中等量の腹水を認め,腸管嚢腫様気腫症(pneumatosis cystoides intestinalis: PCI)の診断となった。バイタルサインが安定し,腹部理学所見で腹膜炎を疑う所見がみられなかったため,gefitinibを休薬して保存的に治療を開始した。自覚症状は徐々に改善し,治療開始7日後の腹部骨盤造影CT検査では画像所見も著明に改善した。
目次
Summary
Pneumatosis cystoides intestinalis(PCI)is a relatively rare condition, characterized by subserosal or submucosal air within the bowel wall. Herein, we report a rare case of PCI secondary to treatment with an epidermal growth factor receptor-tyrosine kinase inhibitor(EGFR-TKI). A 71-year-old man, who had received gefitinib therapy for 2 years and 5 months for lung adenocarcinoma with metastases to the bones and brain, presented with abdominal pain, diarrhea, and vomiting. Computed tomography of the abdomen revealed intramural air in the small bowel, free air in the abdomen, and moderate ascites. A diagnosis of PCI was made, and the patient was managed conservatively by discontinuing gefitinib treatment, because his vital signs were stable and there was no sign of peritonitis. The patient's symptoms gradually improved, and follow-up CT after 1 week revealed that the initial findings had almost completely resolved. Clinicians should note that treatment with gefitinib might cause PCI.
要旨
症例は71歳,男性。骨転移,脳転移を伴う肺腺癌に対して,2年5か月前よりgefitinib(250 mg/日)を連日投与され,安定(stable disease: SD)を維持中に腹痛,下痢,嘔吐を発症した。腹部骨盤造影CT検査を施行すると小腸壁内ガス像,腹腔内遊離ガス像,中等量の腹水を認め,腸管嚢腫様気腫症(pneumatosis cystoides intestinalis: PCI)の診断となった。バイタルサインが安定し,腹部理学所見で腹膜炎を疑う所見がみられなかったため,gefitinibを休薬して保存的に治療を開始した。自覚症状は徐々に改善し,治療開始7日後の腹部骨盤造影CT検査では画像所見も著明に改善した。