title: Metastatic renal cell carcinoma complicated with diffuse alveolar hemorrhage: a rare adverse effect of sunitinib.
abstract: We report the case of a 67-year-old man with metastatic papillary renal cell carcinoma (RCC) who developed bloody sputum after the administration of sunitinib. Chest computed tomography revealed diffuse ground-glass opacity lesions, and bloody bronchoalveolar lavage fluid was obtained by flexible bronchoscopy. The abnormal shadows promptly regressed after withdrawal of sunitinib. In four cycles of sunitinib treatment, he suffered from controllable diffuse alveolar hemorrhage. Finally, he died of respiratory failure 8 months after onset. This is the first case report of diffuse alveolar hemorrhage as an adverse effect of sunitinib in metastatic papillary RCC. Care should be taken with pulmonary hemorrhage in the use of anti-angiogenesis agents in not only squamous cell lung cancer, but also metastatic lung tumors.
authors.affiliation: Cancer Center, Kanazawa University, 13-1 Takara-machi, Kanazawa 920-8641, Japan. tadaakiy@med.kanazawa-u.ac.jp
authors.forename: Tadaaki
authors.initials: T
authors.lastname: Yamada
authors.forename: Koushiro
authors.initials: K
authors.lastname: Ohtsubo
authors.forename: Kouji
authors.initials: K
authors.lastname: Izumi
authors.forename: Shinji
authors.initials: S
authors.lastname: Takeuchi
authors.forename: Hisatsugu
authors.initials: H
authors.lastname: Mouri
authors.forename: Kaname
authors.initials: K
authors.lastname: Yamashita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yasumoto
authors.forename: Peter
authors.initials: P
authors.lastname: Ghenev
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kitagawa
authors.forename: Seiji
authors.initials: S
authors.lastname: Yano
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects; D001992:Bronchoalveolar Lavage Fluid; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000188:drug therapy / Q000556:secondary*; D006470:Hemorrhage / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000150:complications / Q000188:drug therapy / Q000556:secondary; D008175:Lung Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D011650:Pulmonary Alveoli / Q000187:drug effects* / Q000473:pathology; D011758:Pyrroles / Q000009:adverse effects*; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib