November 12, 2014
Notes: Gurusamy, Kurinchi Selvan
Davidson, Brian R
Research Support, Non-U.S. Gov’t
Cochrane Database Syst Rev. 2013 Sep 2;9:CD010326. doi: 10.1002/14651858.CD010326.pub2.
Author Address: Department of Surgery, Royal Free Campus, UCL Medical School, Royal Free Hospital,, Rowland Hill Street, London, UK, NW3 2PF.
Reference Type: Journal Article
Record Number: 4945Author: Gurzu, S., Jung, I., Comsulea, M., Kadar, Z., Azamfirei, L. and Molnar, C.
Title: Lethal cardiotoxicity, steatohepatitis, chronic pancreatitis, and acute enteritis induced by capecitabine and oxaliplatin in a 36-year-old woman
Journal: Diagn Pathol
Short Title: Lethal cardiotoxicity, steatohepatitis, chronic pancreatitis, and acute enteritis induced by capecitabine and oxaliplatin in a 36-year-old woman
Alternate Journal: Diagnostic pathology
ISSN: 1746-1596 (Electronic)
Accession Number: 24041405
Keywords: Acute Disease
Ampulla of Vater/*drug effects/pathology/surgery
Antineoplastic Combined Chemotherapy Protocols/*adverse effects
Common Bile Duct Neoplasms/*drug therapy/pathology/surgery
Deoxycytidine/adverse effects/analogs & derivatives
Drug-Induced Liver Injury/diagnosis/*etiology/therapy
Fatty Liver/*chemically induced/diagnosis/therapy
Fluorouracil/adverse effects/analogs & derivatives
Heart Diseases/*chemically induced/diagnosis/therapy
Multiple Organ Failure/chemically induced
Organoplatinum Compounds/adverse effects
Pancreatitis, Chronic/*chemically induced/diagnosis/therapy
Abstract: A 36-year-old female was hospitalized with symptoms suggesting intestinal occlusion. She was diagnosed with adenocarcinoma of the ampulla of Vater (pT4N0 stage) and underwent cephalic duodenopancreatectomy 8 months ago. Five cycles of postoperative chemotherapy were administrated using capecitabine and oxaliplatin (CAPOX or XELOX), the last one being completed 1 month ago. During the present hospitalization, because of normal computed tomography and ultrasound abdominal examination, rehydration and antibiotherapy were administrated. However, 4 days after hospital admission, the patient died. At autopsy and histological examination, we found a severe myocardial sclerosis with large scarring areas, severe steatohepatitis, chronic pancreatitis with large fibrotic areas, and acute enteritis. Alcohol consumption was denied. The patient died due to associated heart, liver and pancreatic failure. This multiorgan toxicity and death following CAPOX regimen had not yet been reported in the literature. VIRTUAL SLIDES: The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/6472150549833105.