title: Case report of perforation of an ileal neobladder after treatment of rectal cancer with bevacizumab and comment on mechanisms of intestinal perforation associated with bevacizumab.
abstract: OBJECTIVE
  Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF) that has activity in several types of malignancies. One of the uncommon adverse effects is spontaneous bowel perforation. In patients who have undergone cystectomy, a loop of small bowel is often used to create a neobladder. We report the first case of ileal neobladder perforation associated with bevacizumab.
  
  
  METHODS
  We describe a 38-year-old male with metastatic rectal cancer who was receiving treatment with bevacizumab when he presented with acute abdominal pain. Radiographic evaluation revealed perforation of his ileal neobladder.
  
  
  CONCLUSIONS
  We describe the first report of ileal neobladder perforation in the setting of bevacizumab therapy. Although bowel perforation is a well-documented adverse effect of bevacizumab, this case suggests that displaced bowel tissue is still susceptible to these effects. We comment on what is known about bevacizumab-associated intestinal perforation.
authors.affiliation: Division of Medical Oncology, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA. stephen.liu@usc.edu
authors.forename: S V
authors.initials: SV
authors.lastname: Liu
authors.forename: R
authors.initials: R
authors.lastname: Gollard
authors.forename: S
authors.initials: S
authors.lastname: Iqbal
mesh_terms: D000328:Adult; D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects* / Q000627:therapeutic use*; D000068258:Bevacizumab; D006801:Humans; D007082:Ileum / Q000601:surgery; D007416:Intestinal Perforation / Q000139:chemically induced* / Q000601:surgery; D008297:Male; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000601:surgery
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab