title: Two cases of bowel perforation associated with sunitinib treatment for renal cell carcinoma.
abstract: Sunitinib, a multitargeted tyrosine kinase inhibitor, is widely used in the treatment of carcinoma. Adverse events associated with this treatment, including fatigue, diarrhea, and hematotoxicity, have been reported in clinical trials. Bowel perforation is a surgical emergency that requires immediate treatment depending on the location and progression of the tumor. We report 2 cases of bowel perforation during sunitinib treatment. The patients presented with diffuse peritonitis, and emergency exploratory laparotomy was performed. We speculate that the underlying mechanisms were decrease in capillary density of the normal mucosa in case 1 and tumor shrinkage because of sunitinib treatment in case 2. To the best of our knowledge, this is the first study to report the pathological findings implicating bowel perforation due to sunitinib treatment. Further investigations are needed to clarify the risk factors for intestinal perforations associated with sunitinib treatment.
authors.affiliation: Department of Surgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Hoshino
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Hasegawa
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ishii
authors.forename: Takashi
authors.initials: T
authors.lastname: Endo
authors.forename: Hiroki
authors.initials: H
authors.lastname: Ochiai
authors.forename: Koji
authors.initials: K
authors.lastname: Okabayashi
authors.forename: Gou
authors.initials: G
authors.lastname: Kaneko
authors.forename: Shuji
authors.initials: S
authors.lastname: Mikami
authors.forename: Makio
authors.initials: M
authors.lastname: Mukai
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D002292:Carcinoma, Renal Cell / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D007416:Intestinal Perforation / Q000150:complications / Q000473:pathology; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010538:Peritonitis / Q000139:chemically induced / Q000150:complications / Q000601:surgery; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects*; D000077210:Sunitinib
chemical_list: D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib