Fatal hemorrhage in a patient with advanced soft tissue sarcoma following radiation and pazopanib treatment: A case report

Kawasaki,Kenta; Hamamoto,Yasuo; Fukada,Junichi; Adachi,Masayuki; Sasaki,Hikaru; Takaishi,Hiromasa; Yoshida,Kazunari; Kanai,Takanori

doi:10.3892/ol.2016.4246

Fatal hemorrhage in a patient with advanced soft tissue sarcoma following radiation and pazopanib treatment: A case report

Authors:
- Kenta Kawasaki
- Yasuo Hamamoto
- Junichi Fukada
- Masayuki Adachi
- Hikaru Sasaki
- Hiromasa Takaishi
- Kazunari Yoshida
- Takanori Kanai
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Affiliations: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160‑8587, Japan, Keio Cancer Center, Keio University School of Medicine, Tokyo 160‑8587, Japan, Department of Radiology, Keio University School of Medicine, Tokyo 160‑8587, Japan, Department of Neurosurgery, Keio University School of Medicine, Tokyo 160‑8587, Japan
Published online on: February 18, 2016 https://doi.org/10.3892/ol.2016.4246
Pages: 2408-2410
Copyright: © Kawasaki et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

A 71-year-old Japanese woman presented to the Department of Neurosurgery of Keio University School of Medicine (Tokyo, Japan) with a leiomyosarcoma originating in the infratemporal fossa and an 85‑mm metastasis to the right lung. Since the pulmonary lesion was associated with risk of airway obstruction, radiation therapy (50 Gy/20 fractions) was administered to the patient, which resulted in remarkable tumor shrinkage. Subsequently, the patient was administered 800 mg/day pazopanib for 10 weeks, which resulted in further reduction in tumor size. However, the patient succumbed to a massive hemorrhage of sudden onset. Three possible explanations for the fatal hemorrhage are: i) adverse reaction to pazopanib; ii) side effects of radiation; and iii) remarkable tumor shrinkage. As a result, it may be proposed that the synergic effects of the aforementioned hypotheses may have been responsible for the bleeding observed in the present case. Therefore, clinicians should be alert to the possibility of this adverse event. In the present study, the first case of mortality due to massive hemorrhage following remarkable tumor shrinkage induced by radiation therapy and subsequent pazopanib treatment is reported.

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