Malalagama Geethal N, Chryssidis Steve, Parnis Francis X
Department of Medical Imaging, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Department of Oncology, Adelaide Cancer Centre, Kuralta Park, South Australia, Australia.
Cancer Imaging. 2017 Jun 24;17(1):17. doi: 10.1186/s40644-017-0119-3.
Haematuria and pelvic pain are recognized and documented adverse reactions related to Cabazitaxel use. To date there has not been any documentation of imaging findings in patients with this presentation.
We report a case series of five patients who experienced these symptoms while on Cabazitaxel and were all found to have very similar urothelial changes on CT. The patients were noted to have ureteric and renal pelvic dilatation along with urothelial enhancement (in those who had post contrast imaging). All of these changes were noted to be reversible in those who had follow up imaging after cessation of Cabazitaxel and initiation of a short course of steroids.
This case series helps demonstrate the pathological reversible urothelial inflammatory changes that may be occurring in patients experiencing haematuria and pelvic pain on Cabazitaxel therapy. These changes may relate to direct toxic effect of drug metabolites, a radiation recall type phenomenon or a combination of both.
血尿和盆腔疼痛是公认的与使用卡巴他赛相关的不良反应,且有文献记载。迄今为止,尚无关于出现这种症状的患者影像学表现的文献。
我们报告了一个包含五名患者的病例系列,这些患者在使用卡巴他赛期间出现了上述症状,并且在CT上均发现有非常相似的尿路上皮改变。患者被发现存在输尿管和肾盂扩张,以及尿路上皮强化(在进行了对比剂增强成像的患者中)。在停用卡巴他赛并开始短期使用类固醇激素后进行随访成像的患者中,所有这些改变均被发现是可逆的。
该病例系列有助于证明在接受卡巴他赛治疗时出现血尿和盆腔疼痛的患者中可能发生的病理性可逆性尿路上皮炎症改变。这些改变可能与药物代谢产物的直接毒性作用、放射性回忆型现象或两者的结合有关。