Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Head Neck. 2013 Sep;35(9):E269-71. doi: 10.1002/hed.23123. Epub 2012 Aug 23.
Arterial thromboses following cisplatin-based chemotherapy in head and neck cancers are extremely rare and devastating complication.
A 54-year-old male smoker had an acute history of left lower limb pain and calf claudication 3 days following the first cycle of cisplatin-based chemotherapy given concurrently with radiotherapy for squamous cell carcinoma of the base of tongue. CT angiography showed extensive abdominal aortic thrombus along with involvement of left common iliac, saphenopopliteal, and tibeal arteries as well as moderate stenosis in the proximal segments of left anterior descending and right coronary artery. We suggest that endothelial damage and hypercoaguable state secondary to cisplatin may have induced severe arterial and coronary thrombosis.
This is the first reported case of acute multiple arterial thrombosis following cisplatin in head and neck cancer. It is a dreaded complication and has a dismal prognosis if not promptly recognized and treated.
头颈部癌症患者接受顺铂为基础的化疗后发生动脉血栓栓塞极其罕见，但后果严重。
一名 54 岁男性吸烟者，在接受顺铂为基础的化疗（同期联合放疗）治疗舌根鳞状细胞癌一个疗程后 3 天，出现左下肢疼痛和小腿跛行的急性病史。CT 血管造影显示广泛的腹主动脉血栓形成，同时累及左髂总动脉、股浅动脉和胫动脉，以及左前降支和右冠状动脉近端节段的中度狭窄。我们认为，顺铂引起的内皮损伤和高凝状态可能导致了严重的动脉和冠状动脉血栓形成。
这是首例报道的头颈部癌症患者顺铂治疗后发生急性多发性动脉血栓栓塞的病例。如果不能及时识别和治疗，这是一种可怕的并发症，预后不良。
