J Korean Soc Radiol.  2018 Sep;79(3):166-170. 10.3348/jksr.2018.79.3.166.

Acute Aortic Thrombosis Following Capecitabine Chemotherapy in a Patient with Colon Cancer

• Lee MK
• Kim EY
• Kim YS
• Sym SJ
• Kim JH

• KMID: 2418658
• DOI: http://doi.org/10.3348/jksr.2018.79.3.166

Abstract

The elevated risk for thromboembolic events in cancer patients has been well documented. Chemotherapy is considered to be one of the most important risk factors for cardiovascular complications such as arrhythmias, cardiomyopathy, angina, and myocardial infarction. However, acute aortic thrombosis is an extremely rare complication in patients receiving chemotherapy. The authors report a case of acute aortic thrombosis after adjuvant capecitabine chemotherapy for colon cancer.

MeSH Terms

Arrhythmias, Cardiac
Capecitabine*
Cardiomyopathies
Colon*
Colonic Neoplasms*
Drug Therapy*
Fluorouracil
Humans
Mesenteric Ischemia
Myocardial Infarction
Risk Factors
Thrombosis*
Capecitabine
Fluorouracil

Figure

• 

  Fig. 1 Acute aortic thrombosis following capecitabine chemotherapy in a 63-year-old man with colon cancer. A, B. At the time of diagnosis, contrast-enhanced CT imaging revealed mild atherosclerosis in the aorta (arrows in A) and superior mesenteric artery (arrows in B). C, D. After the second cycle of capecitabine chemotherapy (C), contrast-enhanced coronal CT imaging revealed a long segmental thrombus (arrows) at the right aortic wall involving a region from the distal descending thoracic to the suprarenal abdominal aorta. (D) Contrast-enhanced axial CT image revealing thrombus (arrow) at the superior mesenteric artery. E, F. Follow-up CT imaging performed after 2 months of treatment with anticoagulant and capecitabine chemotherapy. At this time, the patient visited the emergency department complaining of severe abdominal pain and distension. (E) Contrast-enhanced axial image revealing portal vein gas (arrows) and pneumoperitoneum (arrowhead). (F) Coronal image revealing gas tracks along the bowel wall, appearing as either linear or rounded cystic collections (arrows), suggestive of pneumatosis intestinalis. Long segmental thrombus (asterisk) remained present in the aorta.

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