Transient cortical blindness during chemotherapy (PVB) for ovarian germ cell tumor.
A 17 year-old female with stage IIIc endodermal sinus tumor of the ovary developed transient cortical blindness and severe hypertension after 5 cycles of PVB regimen consisting of cisplatin, vinblastine and bleomycin. Clinical and radiological findings were compatible with Posterior LeukoEncephalopathy (PLE). Her visual acuity and blood pressure completely recovered within a few days after supportive treatment with antihypertensive drug. This condition is unpredictable but it can be reversible without long term sequelae. Most reports suggested that this rare toxicity was from cisplatin therapy. However, the exact pathophysiogenesis of this condition was not known precisely. Prompt reduction in blood pressure and withdrawal of immunosuppressive agents might lead to rapid reversal of this syndrome and prevent permanent brain damage.
Manchana
Tarinee
T
Gynecologic Oncology Unit, Department of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. T_manchana@hotmail.com
Sirisabya
Nakarin
N
Lertkhachonsuk
Ruangsak
R
Tresukosol
Damrong
D
D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage* / Q000009:adverse effects*; D019575:Blindness, Cortical / Q000139:chemically induced*; D001927:Brain Diseases / Q000139:chemically induced* / Q000473:pathology*; D002945:Cisplatin / Q000008:administration & dosage* / Q000009:adverse effects*; D018240:Endodermal Sinus Tumor / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009367:Neoplasm Staging; D010051:Ovarian Neoplasms / Q000188:drug therapy*; D014747:Vinblastine / Q000008:administration & dosage* / Q000009:adverse effects*
D001761:Bleomycin; D014747:Vinblastine; D002945:Cisplatin