Nasal septum perforation induced by bevacizumab therapy for metastatic colorectal cancer

BMJ Case Rep. 2024 Dec 5;17(12):e263121. doi: 10.1136/bcr-2024-263121.

Abstract

Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor receptors, has become a widely used treatment for various types of cancer, including metastatic colorectal cancer. However, while the benefits of bevacizumab in improving survival outcomes have been well-documented, it is important to consider the potential adverse effects associated with this therapy. We report a case of a male patient in his 50s with a history of metastatic colorectal cancer who began a regimen of bevacizumab in combination with chemotherapy. After several months of treatment, the patient began to experience rhinorrhoea and nasal crusting. Physical examination revealed a perforation of the nasal septum. While nasal septum perforation (NSP) is a known adverse effect of bevacizumab therapy, it is an uncommon occurrence, with only a few reported cases in the literature. Although no further extension of the NSP has been observed during the follow-up period, the treatment with bevacizumab was discontinued.

Keywords: Colon cancer; Ear, nose and throat/otolaryngology.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / adverse effects
  • Antineoplastic Agents, Immunological* / adverse effects
  • Bevacizumab* / administration & dosage
  • Bevacizumab* / adverse effects
  • Colorectal Neoplasms* / drug therapy
  • Colorectal Neoplasms* / pathology
  • Humans
  • Male
  • Middle Aged
  • Nasal Septal Perforation* / chemically induced
  • Nasal Septum / pathology

Substances

  • Bevacizumab
  • Antineoplastic Agents, Immunological
  • Angiogenesis Inhibitors