Acute lower limb ischemia complicating pemetrexed and carboplatin combination chemotherapy for malignant pleural mesothelioma

Ann Ital Chir. 2014 Nov 3;85(ePub):S2239253X14023019.

Abstract

Pemetrexed and Carboplatin are two well-known chemioterapic agents used for the treatment of many tumors, especially for lung cancer and mesothelioma. Peripheral ischemic events related to Pemetrexed and Carboplatin are rarely reported. We herein report a case of lower limb acute ischemia related to combined treatment of Pemetrexed and Carboplatin. A 68-year-old woman was given the chemiotherapic treatment with combination of Pemetrexed and Carboplatin after pleural resection for a malignant pleural mesothelioma. Immediately after the second cycle of treatment, the patient experienced sudden acute left lower limb ischemia. Symptoms resolved after an intra-operative thrombolytic and spasmolytic therapy.

Il Pemetrexed ed il carboplatino sono farmaci chemioterapici di uso corrente nel trattamento di molti tumori, in particolar modo del cancro del polmone e del mesothelioma pleurico. In letteratura sono raramente riportate complicanze ischemiche periferiche relative all’uso del pemetrexed e del carboplatino. Scopo di questo lavoro è descrivere un caso di ischemia acuta d’arto dopo trattamento con pemetrexed e carboplatino. Una donna di 68 anni fu sottoposta a ciclo chemioterapico con pemetrexed e carboplatino dopo decorticazione pleurica per un mesotelioma pleurico maligno. Alla conclusione del secondo ciclo di trattamento, la paziente sviluppò improvvisa ischemia acuta all’arto inferiore sinistro. Trasportata d’urgenza presso il nostro Istituto, fu sottoposta ad esame arteriografico e successivo trattamento trombolitico e spasmolitico trans-catetere che portarono alla completa risoluzione del quadro clinico.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Carboplatin / adverse effects
  • Female
  • Fibrinolytic Agents / administration & dosage*
  • Humans
  • Ischemia / chemically induced*
  • Ischemia / drug therapy
  • Leg / blood supply*
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / surgery
  • Mesothelioma / drug therapy
  • Mesothelioma / surgery
  • Mesothelioma, Malignant
  • Pemetrexed / adverse effects
  • Pleural Neoplasms / drug therapy
  • Pleural Neoplasms / surgery
  • Thrombolytic Therapy* / methods
  • Treatment Outcome
  • Urokinase-Type Plasminogen Activator / administration & dosage*

Substances

  • Fibrinolytic Agents
  • Pemetrexed
  • Carboplatin
  • Urokinase-Type Plasminogen Activator