Medical Oncology Department, University Hospital 12 de Octubre, Madrid, Spain.
Nuclear Medicine Department, University Hospital 12 de Octubre, Madrid, Spain.
J Med Case Rep. 2021 Mar 2;15(1):109. doi: 10.1186/s13256-020-02581-9.
Pneumatosis intestinalis (PI) is a rare entity which refers to the presence of gas within the wall of the small bowel or colon which is a radiographic sign. The etiology and clinical presentation are variable. Patients with PI may present either with chronic mild non-specific symptoms or with acute abdominal pain with peritonitis. Some cases of intestinal pneumatosis have been reported as adverse events of new oncological treatments such as targeted therapies that are widely used in multiple tumors.
A 59-year-old caucasian female with radioactive iodine-refractory metastatic thyroid papillary carcinoma with BRAF mutation was treated with dabrafenib and trametinib as a compassionate use. After 4 months treatment, positron emission tomography-computed tomography (PET-CT) showed PI. At the time of diagnosis, the patient was asymptomatic without signs of peritonitis. The initial treatment was conservative and no specific treatment for PI was needed. Unfortunately, after dabrafenib-trametinib withdrawal, the patient developed tumor progression with significant clinical worsening.
This case report is, in our knowledge, the first description of PI in a patient treated with dabrafenib-trametinib. Conservative treatment is feasible if there are no abdominal symptoms.
肠气肿（PI）是一种罕见的病症，是指小肠或结肠壁内存在气体，这是一种放射学征象。其病因和临床表现多种多样。PI 患者可能表现为慢性轻度非特异性症状，也可能表现为伴有腹膜炎的急性腹痛。有些肠气肿病例被报道为新的肿瘤治疗（如广泛用于多种肿瘤的靶向治疗）的不良事件。
一位 59 岁的白人女性，患有放射性碘难治性转移性甲状腺乳头状癌，BRAF 突变，接受了达布拉非尼和曲美替尼的同情治疗。治疗 4 个月后，正电子发射断层扫描-计算机断层扫描（PET-CT）显示有 PI。在诊断时，患者无症状，无腹膜炎迹象。初始治疗为保守治疗，无需针对 PI 的特殊治疗。不幸的是，在停用达布拉非尼-曲美替尼后，患者出现肿瘤进展，临床状况显著恶化。
据我们所知，这是首例接受达布拉非尼-曲美替尼治疗的患者发生 PI 的病例报告。如果没有腹部症状，保守治疗是可行的。
