engleski

Unusual scrotal and penile ulcerations together with palmar-plantar erythrodysesthesia syndrome in a patient with metastatic colon carcinoma treated with capecitabine

Capecitabine is an orally administered chemotherapeutic drug used in the treatment of colorectal and breast cancer, as well as of metastatic disease, either as a single agent or combined withother agents. A 63-year-old man presented with painful penile and scrotal ulcerations. Four years prior to admission, the patient underwent ileocecal resection for caecum cancer (pT3, N1, M0, Duke‘s C) with metastases in the mesocolic lymph nodes. He received six cycles of Mayo Clinic adjuvant regimen consisting of 5-fluorouracil (5-FU) and leucovorin (folinic acid). Three years after resection, positron emission tomography- computed tomography revealed metastases in the mediastanal and para-aortic lymph modes and lungs. Following the surgical treatment, the pathohistological finding was consistent with metastatic adenocarcinoma of the colon. Two months after the second surgery, the patient was started on XELIRI (irinotecan and capecitabine) + bevacizumab. At the end of the first cycle, the patient was complaining of tingling and burning sensation on the tips of his fingers and toes. During the second cycle, he was complaining of the painful redness of his feet and palms. At the beginning of the fourth cycle of chemotherapy, erythema was followed by painful ulcerations of his penis and scrotum. Capecitabine was thus discontinued. The penile and scrotal ulcerations together with the hand and foot symptoms resolved within 3 weeks of discontinuing capecitabine. Three months after reintroducing capecitabine, the patient redeveloped genital and scrotal redness and ulcerations, together with hand and foot redness. The most common cutaneous side-effect of capecitabine is hand-foot syndrome, also known as PPE. Other cutaneous adverse reactions such as alopecia, nail changes, skin discoloration, cutaneous hyperpigmentation, photosensitivity reaction and radiation recall syndrome have also been reported. This case represents a rare side-effect of capecitabine. Based on the significant pain and discomfort that our patient suffered, it is important for practitioners to recognize this entity as a side-effect of capecitabine, in order to minimize discomfort and complications.

scrotal and penile ulcerations ; palmar-plantar erythrodysesthesia syndrome ; metastatic colone ; capecitabine

nije evidentirano