FELD better not thinking of metastases only when liver lesions appear after bleomycin-based treatment for non-seminoma testis from metastases

BMC Cancer. 2013 Oct 22:13:491. doi: 10.1186/1471-2407-13-491.

Abstract

Background: Bleomycin has become an integral part of chemotherapy in patients with germ-cell tumors. One of the most feared side effects is bleomycin-induced pneumonitis. In patients with mild or moderate BIP, radiological signs disappear almost completely within nine months after discontinuation of bleomycin treatment.

Case presentation: We present a patient with a history of non seminoma of the testis and bleomycin-induced pneumonitis. During follow-up, regression of the hypothesis of eosinophilic migration to the liver after regression of bleomycin-induced pneumonitis is highly suspicious based on transient eosinophilia and focal eosinophilic liver disease.

Conclusion: As follow up may consist of CT scanning in germ-line tumor patients, transient eosinophilic liver lesions reported during regressive bleomycin-induced pneumonitis should not be presumed automatically as metastatic tumor relapse and require further sequential imaging and pathological examination.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Antibiotics, Antineoplastic / adverse effects*
  • Antibiotics, Antineoplastic / therapeutic use
  • Bleomycin / adverse effects*
  • Bleomycin / therapeutic use
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / pathology*
  • Eosinophilia / chemically induced
  • Humans
  • Lymphocytes / pathology
  • Magnetic Resonance Imaging
  • Male
  • Neoplasm Staging
  • Testicular Neoplasms / complications*
  • Testicular Neoplasms / drug therapy
  • Testicular Neoplasms / pathology
  • Tomography, X-Ray Computed

Substances

  • Antibiotics, Antineoplastic
  • Bleomycin