title: Bowel perforation in non-small cell lung cancer after bevacizumab therapy.
abstract: BACKGROUND
  Bevacizumab is increasingly used in combination with chemotherapy for treatment of unresectable non-small cell lung cancer. The aim of this report is to underline possible risks associated with this otherwise well-tolerated drug.
  
  
  METHODS
  A 69-year-old patient with metastatic non-small cell lung cancer was started on a palliative chemotherapy regimen containing carboplatin, paclitaxel, and bevacizumab.
  
  
  RESULTS
  After the second cycle of chemotherapy, the patient developed abdominal pain. On emergency laparotomy, there was diffuse perforation of the colonic wall, so the patient underwent a Hartmann's procedure with subtotal colectomy. Histopathological examination confirmed the diagnosis of ischemic colitis.
  
  
  CONCLUSIONS
  Gastrointestinal perforation is a known adverse event of bevacizumab therapy which so far has occurred only in patients with predisposing risk factors. Our patient illustrates that there must always remain a high index of suspicion regarding bowel perforation in patients developing acute abdominal pain under bevacizumab therapy, even if they have no apparent risk factors.
authors.affiliation: Chirurgische Klinik I, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. elisabeth.schellhaas@charite.de
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schellhaas
authors.forename: Christoph
authors.initials: C
authors.lastname: Loddenkemper
authors.forename: Alexander
authors.initials: A
authors.lastname: Schmittel
authors.forename: Heinz-J
authors.initials: HJ
authors.lastname: Buhr
authors.forename: Uwe
authors.initials: U
authors.lastname: Pohlen
mesh_terms: D000368:Aged; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D016190:Carboplatin / Q000008:administration & dosage / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007416:Intestinal Perforation / Q000139:chemically induced*; D008175:Lung Neoplasms / Q000150:complications* / Q000188:drug therapy; D008297:Male; D017239:Paclitaxel / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D016190:Carboplatin; D017239:Paclitaxel