[A case of leukoencephalopathy caused by HCFU].
After a hysterectomy, a bilateral salpingo-oophorectomy, two courses of intra-peritoneal chemotherapy of Cisplatinum, Carmofur (HCFU, 600 mg/day [per os]) were given a patient who had ovarian granulosa cell tumor (malignant, stage Iai). Dizziness and loss of consciousness developed about 60 days after administration of HCFU, and leucoencephalopathy was diagnosed. A CT revealed a diffuse low density area in the white matter of the cerebrum. Myelin Basic Protein in the spinal fluid was found to amount to 9.8 mg/dl, which in norm. person is less than 4.0 mg/dl. Also, it showed parallel changes with the course of the clinical findings. HCFU easily dissolves to fat and changes to 5-FU without enzymes in the liver cell. Further HCFU also passes through Blood Brain Barrier to Produce 5-FU and its derivatives, in which the alpha-Fluoro-beta-Alanine is thought to be the culprit that brings on leucoencephalopathy. Even so, HCFU should be dosed when needed in spite of this risk. Other 5-FU modifiers also have been reported to produce the same effect in several cases.
Kamata
H
H
Dept. of Gynecology, Tokyo Metropolitan Komagome Hospital.
Murakami
A
A
Miyagawa
N
N
Yasui
H
H
Nagano
H
H
Abe
S
S
Ueda
K
K
Kisida
S
S
D000328:Adult; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001812:Blood-Brain Barrier; D001927:Brain Diseases / Q000139:chemically induced* / Q000503:physiopathology; D002945:Cisplatin / Q000008:administration & dosage; D003131:Combined Modality Therapy; D004569:Electroencephalography; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000378:metabolism; D006106:Granulosa Cell Tumor / Q000188:drug therapy* / Q000601:surgery; D006801:Humans; D007044:Hysterectomy; D009378:Neoplasms, Multiple Primary / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000601:surgery; D010052:Ovariectomy; D013724:Teratoma / Q000188:drug therapy* / Q000601:surgery
D000970:Antineoplastic Agents; C017367:carmofur; D002945:Cisplatin; D005472:Fluorouracil