Inferior mesenteric arteriovenous fistula during treatment with bevacizumab in colorectal cancer patient: A case report

作     者：Ayako Doi Hiroyuki Takeda Kumiko Umemoto Ryosuke Oumi Shinji Wada Shingo Hamaguchi Hidefumi Mimura Hiroyuki Arai Yoshiki Horie Takuro Mizukami Naoki Izawa Takashi Ogura Takako EguchiNakajima Yu Sunakawa 

作者机构：Department of Clinical OncologySt.Marianna University School of MedicineKanagawa 216-8511Japan Department of GastroenterologySt.Marianna University School of MedicineKanagawa 216-8511Japan Department of RadiologySt.Marianna University School of MedicineKanagawa 216-8511Japan Innovation Center for Next Generation Clinical Trials and iPS Cell TherapyKyoto University HospitalKyoto 606-8507Japan 

出 版 物：《World Journal of Gastrointestinal Oncology》 (世界胃肠肿瘤学杂志（英文版）（电子版）)

年 卷 期：2020年第12卷第11期

页      面：1364-1371页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Metastatic cancer Colon surgery Chemotherapy Fistula formation Inferior mesenteric artery Interventional radiology Case report 

摘      要：BACKGROUND Fistula formation is a severe adverse event related to antiangiogenetic agents such as bevacizumab and inferior mesenteric arteriovenous fistula(IMAVF) is a result of acquired factor, especially colon surgery. However, IMAVF occurs very rarely and there are few reports in patients during chemotherapy. We report a case of a patient who developed IMAVF during treatment with bevacizumab in metastatic colorectal cancer(mCRC) after colon *** SUMMARY An 81-year-old man was diagnosed with descending colon cancer and underwent left hemicolectomy without any complications. He was definitely diagnosed with high-risk stage 2 and received tegafur-uracil plus leucovorin as adjuvant chemotherapy. Three years and 6 mo after the operation, the cancer relapsed with peritoneal dissemination. The patient underwent CyberKnife radiosurgery targeting the recurrent tumor and received chemotherapy with S-1 plus bevacizumab. At 1 year after chemotherapy, he complained of severe diarrhea, which is suspected drug-induced colitis. As diarrhea worsened despite the termination of treatment, he underwent colonoscopy and computed tomography (CT) scans that revealed edematous change from sigmoid to rectosigmoid colon. CT scans also revealed an aneurysm adjacent to the inferior mesenteric vein and multidetector CT angiography showed the IMAVF. Elective angiography confirmed the diagnosis of an IMAVF and it was successfully treated by arterial embolization. The patient resumed chemotherapy with only S-1 6 mo after *** Clinicians should keep in mind the probability of severe diarrhea arose from IMAVF in mCRC patients treated with bevacizumab.