Hemorrhagic pseudoaneurysm in a patient receiving aflibercept for metastatic thyroid cancer Journal Article
| Authors: | Baxi, S. S.; Sherman, E. J.; Kelly, K. W.; Brown, K. T.; DeMatteo, R. P.; Pfister, D. G. |
| Article Title: | Hemorrhagic pseudoaneurysm in a patient receiving aflibercept for metastatic thyroid cancer |
| Abstract: | Background: Agents such as aflibercept, which target the angiogenic pathway, are of great interest as candidates for the management of metastatic differentiated thyroid cancer. Here, we report a patient who developed a hemorrhagic abdominal pseudoaneurysm shortly after being started on this drug. Patient Findings: The patient was a 67-year-old woman being treated with single agent aflibercept (VEGF-Trap) for metastatic thyroid cancer. She had no history of intra-abdominal pathology or vascular disease but had been previously treated with sorafenib. Twelve days after receiving her second dose of aflibercept, she developed vague abdominal pain, which increased in severity and was accompanied by nausea and vomiting. Her symptoms progressed along with a decline in her hematocrit and signs of internal hemorrhaging. An angiogram identified an occluded celiac artery with increased collaterals and a bleeding pseudoaneurysm in the inferior pancreaticoduodenal artery. After the pseudoaneurysm was coiled, the patient stabilized. Summary and Conclusions: Anti-angiogenic agents, usually well tolerated, can disrupt the delicate balance of normal endothelium, leading to hemorrhagic and thrombotic complications. The hemorrhage of aberrant vasculature should be included in the differential diagnosis in patients presenting with vague complaints while being treated with anti-angiogenic agents. © Copyright 2012, Mary Ann Liebert, Inc. |
| Keywords: | treatment outcome; aged; disease course; anamnesis; case report; sorafenib; cancer growth; laparotomy; pancreas; metastasis; computer assisted tomography; dexamethasone; hemoglobin; abdominal pain; hypotension; disease severity; recombinant fusion proteins; aflibercept; neoplasm metastasis; blood transfusion; nausea and vomiting; thyroid cancer; thyroid neoplasms; blood flow; angiogenesis inhibitors; duodenum; abdominal cramp; hydration; hemodynamics; angiography; cerebrovascular accident; hematocrit; bloating; abdominal bleeding; hemorrhage; coil embolization; false aneurysm; aneurysm, false; pancreaticoduodenal artery; hemoperitoneum; celiac angiography; celiac artery stenosis; gastroduodenal artery; hemorrhagic abdominal pseudoaneurysm; retroperitoneal hematoma |
| Journal Title: | Thyroid |
| Volume: | 22 |
| Issue: | 5 |
| ISSN: | 1050-7256 |
| Publisher: | Mary Ann Liebert, Inc |
| Date Published: | 2012-05-01 |
| Start Page: | 552 |
| End Page: | 555 |
| Language: | English |
| DOI: | 10.1089/thy.2011.0413 |
| PROVIDER: | scopus |
| PMCID: | PMC3338952 |
| PUBMED: | 22510046 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 June 2012" - "CODEN: THYRE" - "Source: Scopus" |
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