Acute aortic dissection in a patient receiving multiple tyrosine kinase inhibitors for 5 years.
A 48-year-old male presented with para-aortic lymph node metastases after surgical resection of a clear cell renal cell carcinoma. After first-line treatment with interferon alpha-2b, he was started on pazopanib and lapatinib. Blood pressure was well controlled with temocapril and amlodipine. Treatment had to be stopped 4 years and 8 months after initiation due to overt proteinuria. Then, sunitinib was started as third-line treatment. During the second cycle of sunitinib, he died due to a Stanford type A aortic dissection. Acute aortic dissection could be an adverse event associated with the long-term use of antiangiogenic tyrosine kinase inhibitors.
Department of Urology, Nagoya University Graduate School of Medicine, Nagoya University Hospital, Nagoya, Japan.
Y
Y
Funahashi
Department of Urology, Nagoya University Graduate School of Medicine, Nagoya University Hospital, Nagoya, Japan.
N
N
Sassa
Department Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
M
M
Inada-Inoue
Department Clinical Oncology and Chemotherapy, Nagoya University Hospital, Nagoya, Japan.
Y
Y
Ando
Department of Urology, Nagoya University Graduate School of Medicine, Nagoya University Hospital, Nagoya, Japan.
Y
Y
Matsukawa
Department of Urology, Nagoya University Graduate School of Medicine, Nagoya University Hospital, Nagoya, Japan.
M
M
Gotoh
D000208:Acute Disease; D000784:Aortic Dissection / Q000139:chemically induced* / Q000473:pathology*; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D001014:Aortic Aneurysm / Q000139:chemically induced* / Q000473:pathology*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D017809:Fatal Outcome; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008134:Long-Term Care; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011505:Protein-Tyrosine Kinases / Q000008:administration & dosage / Q000037:antagonists & inhibitors*; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects*; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed
D020533:Angiogenesis Inhibitors; D007211:Indoles; D011758:Pyrroles; D011505:Protein-Tyrosine Kinases; D000077210:Sunitinib