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A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab

BACKGROUND: The angiogenesis inhibitor monoclonal antibody Bevacizumab is presently the standard treatment for numerous neoplasms but particular toxicities are emerging, such as hypertension, haemorrhage, thromboembolism, gastrointestinal perforation, fistulae, and delayed wound healing. The additio...

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Autores principales: Tognarelli, Alessio, Faggioni, Lorenzo, Manassero, Francesca, Gadducci, Angiolo, Selli, Cesare
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902463/
https://www.ncbi.nlm.nih.gov/pubmed/31818277
http://dx.doi.org/10.1186/s12894-019-0566-1
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author Tognarelli, Alessio
Faggioni, Lorenzo
Manassero, Francesca
Gadducci, Angiolo
Selli, Cesare
author_facet Tognarelli, Alessio
Faggioni, Lorenzo
Manassero, Francesca
Gadducci, Angiolo
Selli, Cesare
author_sort Tognarelli, Alessio
collection PubMed
description BACKGROUND: The angiogenesis inhibitor monoclonal antibody Bevacizumab is presently the standard treatment for numerous neoplasms but particular toxicities are emerging, such as hypertension, haemorrhage, thromboembolism, gastrointestinal perforation, fistulae, and delayed wound healing. The addition of Bevacizumab to radio and chemotherapy has improved the overall survival rate in patients with metastatic, persistent or recurrent cervical carcinoma. However an increased risk of enteric or urinary fistula formation has been documented, related to hypoxia which is induced by the inhibition of angiogenesis. Moreover, previous pelvic surgery, repeated ureteral stenting and radiation are additional risk factors. CASE PRESENTATION: We describe the remarkable case of a right ureteral stent displacement inside the rectum lumen in a patient treated with Bevacizumab for pelvic recurrence of cervical cancer. The patient was referred to our Urology Department with urinary sepsis and bilateral hydronephrosis. Right ureteral stent substitution was planned; at cystoscopy the distal loop of the stent was not visualized inside the bladder. The presence of the distal loop of the right ureteral inside the rectum was clearly demonstrated with a CT scan. CONCLUSIONS: Since Bevacizumab is increasingly used in the treatment of gynaecological neoplasms and indwelling ureteral stents are often required to treat or prevent ureteral compressions, similar cases are likely to be diagnosed and this complication should be considered in the management of advanced pelvic cancers.
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spelling pubmed-69024632019-12-11 A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab Tognarelli, Alessio Faggioni, Lorenzo Manassero, Francesca Gadducci, Angiolo Selli, Cesare BMC Urol Case Report BACKGROUND: The angiogenesis inhibitor monoclonal antibody Bevacizumab is presently the standard treatment for numerous neoplasms but particular toxicities are emerging, such as hypertension, haemorrhage, thromboembolism, gastrointestinal perforation, fistulae, and delayed wound healing. The addition of Bevacizumab to radio and chemotherapy has improved the overall survival rate in patients with metastatic, persistent or recurrent cervical carcinoma. However an increased risk of enteric or urinary fistula formation has been documented, related to hypoxia which is induced by the inhibition of angiogenesis. Moreover, previous pelvic surgery, repeated ureteral stenting and radiation are additional risk factors. CASE PRESENTATION: We describe the remarkable case of a right ureteral stent displacement inside the rectum lumen in a patient treated with Bevacizumab for pelvic recurrence of cervical cancer. The patient was referred to our Urology Department with urinary sepsis and bilateral hydronephrosis. Right ureteral stent substitution was planned; at cystoscopy the distal loop of the stent was not visualized inside the bladder. The presence of the distal loop of the right ureteral inside the rectum was clearly demonstrated with a CT scan. CONCLUSIONS: Since Bevacizumab is increasingly used in the treatment of gynaecological neoplasms and indwelling ureteral stents are often required to treat or prevent ureteral compressions, similar cases are likely to be diagnosed and this complication should be considered in the management of advanced pelvic cancers. BioMed Central 2019-12-09 /pmc/articles/PMC6902463/ /pubmed/31818277 http://dx.doi.org/10.1186/s12894-019-0566-1 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Tognarelli, Alessio
Faggioni, Lorenzo
Manassero, Francesca
Gadducci, Angiolo
Selli, Cesare
A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab
title A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab
title_full A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab
title_fullStr A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab
title_full_unstemmed A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab
title_short A case report of endorectal displacement of a right ureteral stent following radiochemotherapy and Bevacizumab
title_sort case report of endorectal displacement of a right ureteral stent following radiochemotherapy and bevacizumab
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6902463/
https://www.ncbi.nlm.nih.gov/pubmed/31818277
http://dx.doi.org/10.1186/s12894-019-0566-1
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