Quattrocchi Carlo C, Alexandre Andrea M, Tonini Giuseppe, Errante Yuri, Grasso Rosario F, Zobel Bruno Beomonte
Interdisciplinary Center for Biomedical Research, Department of Radiology, University Campus Bio-Medico of Rome, via Longoni, 47 I-00155 Rome, Italy.
J Med Case Rep. 2011 Feb 27;5:84. doi: 10.1186/1752-1947-5-84.
Several adverse events have been associated with the use of bevacizumab during the treatment of neoplasms such as colorectal cancer, breast cancer, non-small cell lung cancer, pancreatic cancer and renal cell carcinoma. The present case demonstrates how focal neurological symptoms lead to the magnetic resonance imaging-based differential diagnosis between focal parenchymal metastases and microischemic phenomena, with crucial implications for patient management.
We describe the case of a 37-year-old Italian Caucasian woman with metastatic colon cancer who developed focal neurological symptoms during a chemotherapy regimen involving the use of bevacizumab. Brain magnetic resonance imaging examination revealed millimetric lesions with restricted diffusion without perilesional edema or contrast enhancement after gadodiamide intravenous injection, suggestive of acute microischemic phenomena. This complication is very rare but clinically significant.
The differential diagnosis in patients with cancer undergoing bevacizumab treatment should include microischemic phenomena.
在结直肠癌、乳腺癌、非小细胞肺癌、胰腺癌和肾细胞癌等肿瘤的治疗过程中，使用贝伐单抗已出现了几种不良事件。本病例展示了局灶性神经症状如何导致基于磁共振成像的局灶性实质转移瘤与微缺血现象之间的鉴别诊断，这对患者管理具有关键意义。
我们描述了一名37岁的意大利白人女性转移性结肠癌患者的病例，该患者在使用贝伐单抗的化疗方案期间出现了局灶性神经症状。脑磁共振成像检查显示有毫米级病变，弥散受限，静脉注射钆双胺后无病灶周围水肿或对比增强，提示急性微缺血现象。这种并发症非常罕见，但具有临床意义。
接受贝伐单抗治疗的癌症患者的鉴别诊断应包括微缺血现象。
