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Intra‐abdominal fibrosis after systemic and intraperitoneal therapy containing fluoropyrimidines
Author(s) -
Fata Farid,
Ron Ilan G.,
Maluf Fernando,
Klimstra David,
Kemeny Nancy
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(20000601)88:11<2447::aid-cncr4>3.0.co;2-4
Subject(s) - medicine , carboplatin , carcinoembryonic antigen , floxuridine , gastroenterology , chemotherapy , retroperitoneal fibrosis , malignancy , carcinoma , fluorouracil , fibrosis , surgery , pathology , cisplatin , cancer
BACKGROUND Intra‐abdominal and retroperitoneal fibrosis has been described as secondary to intraperitoneal (IP) administration of several chemotherapeutic agents, including carboplatin, mitoxantrone, and the combination of 5‐fluorouracil and cisplatin. The IP administration of floxuridine (FUDR) is an effective and minimally toxic treatment for patients with metastases to the peritoneum. An increasing number of patients with colorectal, gastric, or ovarian carcinoma are treated with IP chemotherapy. METHODS The authors report two patients with metastatic colon carcinoma who experienced severe intra‐abdominal fibrosis presenting as an intra‐abdominal mass mimicking recurrence in one patient and diffuse encasement of the bowel in the other, after the administration of IP FUDR and leucovorin. RESULTS Two patients with Stage III colon adenocarcinoma received postoperative adjuvant 5‐fluorouracil and levamisole. They subsequently presented with a rise in carcinoembryonic antigen level and isolated liver metastasis. They underwent hepatic lobectomy with postoperative intra‐arterial hepatic FUDR and systemic 5‐fluorouracil and leucovorin. They each had an intra‐abdominal recurrence, which was resected and treated with postoperative IP FUDR and leucovorin. They then presented with a diffuse pattern of IP fibrosis with no tumor identified. CONCLUSIONS IP FUDR and leucovorin therapy can be associated with diffuse IP fibrosis, which in this study caused an intra‐abdominal mass that was indistinguishable from recurrent malignancy in one patient and encasement of the bowel in the other. Cancer 2000;88:2447–51. © 2000 American Cancer Society.