title: [Blindness and symmetrical neurological deficit in a patient with colon cancer receiving adjuvant chemotherapy: is it always cancer?].
abstract: Posterior reversible leukoencephalopathy syndrome [PRES] is characterized by a symmetrical brain edema. It is rarely caused by chemotheraphy. While steroids can lead to deterioration in the condition of a PRES patient, they are still the drug of choice for the more common condition of brain edema secondary to metastases. We describe the case of a colon cancer patient who underwent adjuvant treatment with capecitabine and oxaliplatin and was admitted to the hospital with seizures and brain edema. On admission, the condition was attributed to brain metastases and hence a high dose steroid treatment was initiated. Later on, as the patient became comatose, the CT was revised and PRES was suggested as an alternative diagnosis. After tapering the steroids the patient gradually recovered. This report emphasizes the need to be alert and not to confuse PRES with brain metastasis in cancer patients.
authors.affiliation: Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel..
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Leshem
authors.forename: Shlomit
authors.initials: S
authors.lastname: Fennig
authors.forename: Elisa
authors.initials: E
authors.lastname: Talianski
authors.forename: Gahl
authors.initials: G
authors.lastname: Greenberg
authors.forename: Ido
authors.initials: I
authors.lastname: Wolf
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001766:Blindness / Q000175:diagnosis / Q000209:etiology*; D001932:Brain Neoplasms / Q000175:diagnosis*; D000069287:Capecitabine; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy / Q000473:pathology; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage / Q000031:analogs & derivatives; D006801:Humans; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D012640:Seizures / Q000209:etiology*; D013256:Steroids / Q000008:administration & dosage / Q000009:adverse effects
chemical_list: D009944:Organoplatinum Compounds; D013256:Steroids; D000077150:Oxaliplatin; D003841:Deoxycytidine; D000069287:Capecitabine; D005472:Fluorouracil