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CC BY 4.0 · Brazilian Journal of Oncology 2021; 17: e-20200050
DOI: 10.5935/2526-8732.20200050
Case Report
Clinical Oncology

Spontaneous Atypical Intracerebral Hematoma in a Patient with Metastatic Colon Cancer using Bevacizumab without Central Nervous System Metastases

Hematoma intracerebral atípico espontâneo em um paciente com câncer de cólon metastático em uso de Bevacizumabe sem metástases para o sistema nervoso central

Guilherme Gago da Silva
1   São Jose Hospital, Santa Casa Hospital Complex, Department of Neurological Surgery - Porto Alegre - Rio Grande do Sul - Brazil
,
Antonio Dal Pizzol Junior
2   Santa Rita Hospital, Santa Casa Hospital Complex, Department of Clinical Oncology - Porto Alegre - Rio Grande do Sul - Brazil
,
Alexei Peter dos Santos
2   Santa Rita Hospital, Santa Casa Hospital Complex, Department of Clinical Oncology - Porto Alegre - Rio Grande do Sul - Brazil
,
João Pedro Einsfeld Britz
3   University of Caxias do Sul, Medical school - Caxias do Sul - Rio Grande do Sul - Brazil
,
Paulo Valdeci Worm
1   São Jose Hospital, Santa Casa Hospital Complex, Department of Neurological Surgery - Porto Alegre - Rio Grande do Sul - Brazil
› Author Affiliations Financial support: none to declare.
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ABSTRACT

We report a case of a patient with metastatic colon cancer without central nervous system metastases who presented with a spontaneous intraparenchymal hematoma using bevacizumab, without coagulation disorders or metastatic cells in the pathological examination. Bevacizumab is a

monoclonal antibody against vascular endothelial growth factor (VEGF) that inhibits binding of the normal VEGF ligand to its receptor and is used to treat various tumors. Its therapeutic effect is believed to occur by limiting the formation of new blood vessels in tumors and decreasing their oxygenation. Fatal cerebrovascular events have been reported with the use of bevacizumab, raising the discussion of the safety of its use, especially in patients with brain metastases. At present, controversial remains as to bevacizumab increases the risk of cerebrovascular events.

RESUMO

Relatamos o caso de um paciente com câncer de cólon metastático sem metástases no sistema nervoso central que apresentou hematoma intraparenquimatoso espontâneo em uso de bevacizumabe, sem distúrbios de coagulação ou células metastáticas ao exame anatomopatológico. O bevacizumabe é um anticorpo monoclonal contra o fator de crescimento endotelial vascular (VEGF) que inibe a ligação VEGF ao seu receptor, sendo usado para tratar diversos tumores. Acredita-se que seu efeito terapêutico ocorra limitando a formação de novos vasos sanguíneos nos tumores e diminuindo sua oxigenação. Eventos cerebrovasculares fatais têm sido relatados com o uso de bevacizumabe, levantando a discussão sobre a segurança de seu uso, especialmente em pacientes com metástases cerebrais. No momento, permanece a controvérsia quanto ao bevacizumabe aumentar o risco de eventos cerebrovasculares.

Keywords:

Bevacizumab - Cerebral hemorrhage - Neurosurgery - Intracranial hemorrhages - Antineoplastic agents.

Descritores:

Bevacizumab - Hemorragia cerebral - Neurocirurgia - Hemorragias intracranianas - Agentes antineoplásicos.


Publication History

Received: 09 September 2020

Accepted: 15 September 2020

Article published online:
18 January 2021

© 2022. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Bibliographical Record
Guilherme Gago da Silva, Antonio Dal Pizzol, Alexei Peter dos Santos, João Pedro Einsfeld Britz, Paulo Valdeci Worm. Spontaneous Atypical Intracerebral Hematoma in a Patient with Metastatic Colon Cancer using Bevacizumab without Central Nervous System Metastases. Brazilian Journal of Oncology 2021; 17: e-20200050.
DOI: 10.5935/2526-8732.20200050
 

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