Yonsei Med J.  2011 Jul;52(4):695-698. 10.3349/ymj.2011.52.4.695.

Bowel Perforation after Erlotinib Treatment in a Patient with Non-Small Cell Lung Cancer

• Cheon YH
• Kim MJ
• Kang MG
• Kim HJ
• Lee SS
• Kim CY
• Jeon DH
• Kim YE
• Lee GW

• KMID: 1728007
• DOI: http://doi.org/10.3349/ymj.2011.52.4.695

Abstract

Erlotinib is accepted as a standard second-line chemotherapeutic agent in patients with non-small cell lung cancer who are refractory or resistant to first-line platinum-based chemotherapy. There has been no previous report of bowel perforation with or without gastrointestinal metastases related to erlotinib in patients with non-small cell lung cancer. The exact mechanism of bowel perforation in patients who received erlotinib remains unclear. In this report, we report the first case of enterocutaneous fistula in a female patient with metastatic non-small cell lung cancer 9 months, following medication with erlotinib as second-line chemotherapy.

Keyword

Lung neoplasm; intestinal fistula; erlotinib

MeSH Terms

Aged
Antineoplastic Agents/*adverse effects/therapeutic use
Carcinoma, Non-Small-Cell Lung/complications/*drug therapy
Female
Humans
Intestinal Fistula/*chemically induced/complications/radiography/surgery
Intestinal Perforation/*chemically induced/complications/radiography/surgery
Protein Kinase Inhibitors/*adverse effects/therapeutic use
Quinazolines/*adverse effects/therapeutic use
Sigmoid Diseases/*chemically induced/complications/radiography/surgery

Figure

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  Fig. 1 (A and B) White arrow indicates an enterocutaneous fistula in the sigmoid colon herniation through the abdominal wall defect.

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  Fig. 2 Fistulography shows well passage of contrast media into the sigmoid colon without another fistu.

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  Fig. 3 (A and B) Submucosal edema and serosal hemorrhage of the perforated sigmoid colon.

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