title: Capecitabine-related intracranial hypotension syndrome mimicking dural metastasis in a breast cancer patient: case report and review of the literature.
abstract: Spontaneous intracranial hypotension (SICH) is an entity, which is secondary to iatrogenic manipulation and breaching of dura. Postural headache in patients should be suspected, cranial magnetic resonance imaging (MRI) is essential for precise diagnosis. Hallmark of MRI is regular shape of pachymeningeal gadolinium enhancement and subdural effusion. It may mimic central nervous system (CNS) metastasis. Prevention of such cases from receiving cranial radiotherapy by misinterpretation of the gadolinium enhancement as CNS metastasis is an important issue. Capecitabine is an antineoplastic agent, of which metabolites can cross blood-brain barrier in CNS via epithelial tissue. It may cause decrease in CSF production. SICH might be the clinical reflection of this decrease in CSF production. Review of the English literature revealed limited data because of the very little experience with oncologic patients suffering from intracranial hypotension. We report a case of spontaneous intracranial hypotension during capecitabine treatment. Patient was completely well following drug discontinuation and supportive treatment.
authors.affiliation: Department of Radiation Oncology, Trakya University Medical Faculty, Edirne, Turkey. rusencosar@yahoo.com
authors.forename: Rusen
authors.initials: R
authors.lastname: Cosar-Alas
authors.forename: Aykan
authors.initials: A
authors.lastname: Alas
authors.forename: Alaattin
authors.initials: A
authors.lastname: Ozen
authors.forename: Bengu
authors.initials: B
authors.lastname: Denizli
authors.forename: Mert
authors.initials: M
authors.lastname: Saynak
authors.forename: Sernaz
authors.initials: S
authors.lastname: Uzunoglu
authors.forename: Nurettin
authors.initials: N
authors.lastname: Aydogdu
authors.forename: Hakan
authors.initials: H
authors.lastname: Karagol
authors.forename: Cem
authors.initials: C
authors.lastname: Uzal
authors.forename: Zafer
authors.initials: Z
authors.lastname: Kocak
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D000069287:Capecitabine; D003841:Deoxycytidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D005472:Fluorouracil / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D019585:Intracranial Hypotension / Q000139:chemically induced*; D008875:Middle Aged; D009362:Neoplasm Metastasis
chemical_list: D000970:Antineoplastic Agents; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil