title: Dehiscence of corticosteroid-induced abdominal striae in a 14-year-old boy treated with bevacizumab for recurrent glioblastoma.
abstract: Corticosteroids have been the mainstay for management of cerebral edema caused by leaky angiogenic vessels associated with high-grade brain tumors since the early 1960s. Chronic corticosteroid use can cause iatrogenic Cushing syndrome, which is associated with weight gain and abdominal striae (striae distensae). The anti-vascular endothelial growth factor therapy, bevacizumab, has recently been introduced for the management of recurrent glioblastoma. Vascular endothelial growth factor plays multiple roles in wound healing, including promoting angiogenesis, acting as a chemo-attractant for inflammatory cells, and stimulating collagen production. We report the first pediatric case of a 14-year-old boy with corticosteroid-induced abdominal striae who developed ulceration and dehiscence of the striae following the introduction of bevacizumab therapy. The combination of high-dose corticosteroids and anti-vascular endothelial growth factor therapy may cause significant complications, especially in children who are susceptible to abdominal striae and therefore should be avoided.
authors.affiliation: Department of Medical Oncology, Royal North Shore Hospital, New South Wales, Australia. hrwheeler@optusnet.com.au
authors.forename: Helen
authors.initials: H
authors.lastname: Wheeler
authors.forename: Jason
authors.initials: J
authors.lastname: Black
authors.forename: Suzanne
authors.initials: S
authors.lastname: Webb
authors.forename: Han
authors.initials: H
authors.lastname: Shen
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D018906:Antineoplastic Agents, Alkylating / Q000009:adverse effects; D000068258:Bevacizumab; D003606:Dacarbazine / Q000009:adverse effects / Q000031:analogs & derivatives; D003907:Dexamethasone / Q000009:adverse effects*; D005909:Glioblastoma / Q000188:drug therapy; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D057896:Striae Distensae / Q000139:chemically induced* / Q000473:pathology; D015173:Supratentorial Neoplasms / Q000188:drug therapy; D000077204:Temozolomide; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology*
chemical_list: D000305:Adrenal Cortex Hormones; D061067:Antibodies, Monoclonal, Humanized; D018906:Antineoplastic Agents, Alkylating; D005938:Glucocorticoids; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D003606:Dacarbazine; D003907:Dexamethasone; D000077204:Temozolomide