Cerebral venous sinus thrombosis (CVT) is rare but sometimes develops in association with malignant neoplasm. We report two cases of CVT that occurred during cisplatin-based chemotherapy for ...testicular cancer. A 46-year-old man with stage IIA non-seminomatous germ cell tumour was treated with conventional doses of etoposide and cisplatin (EP). On day 11 of the third treatment course, he developed a systemic seizure. Brain computed tomography (CT) and magnetic resonance (MR) imaging could not detect the cause. Enhanced chest-pelvic CT revealed pelvic thrombosis. Administration of phenytoin for epilepsy of unknown cause and heparin for thrombosis was started. He had completed 4 courses of EP therapy without seizure recurrence. After re-evaluating the brain CT images retrospectively, we found high density of superior sagittal sinus (SSS) and strongly suspected CVT. Another patient was a 47-year-old man with stage IIIB seminomatous germ cell tumour treated with bleomycin, etoposide, and cisplatin (BEP) therapy. On day 11 of the second treatment course, he developed a systemic seizure. Brain CT revealed subarachnoid haemorrhage localised in the right parietal lobe. CT venography revealed a filling defect in the superior sagittal sinus (SSS). MR venography revealed a SSS stenosis. We diagnosed the cause of the seizure as CVT and started administration of anticoagulant therapy. After the thrombus had diminished, chemotherapy was restarted and another 2 courses of BEP therapy was completed.
A 74-year-old woman who had previously undergone left nephrectomy because of calculi was referred to our department with a right renal mass that was detected by computed tomography (CT) during ...treatment for pyelonephritis. Repeated CT showed a contrast-enhanced 4.7 cm tumor close to the renal sinus, and no metastatic lesion was detected. Sunitinib was administered as a presurgical therapy ; however, the patient experienced grade 3 neutropenia and thrombocytopenia, and sunitinib was discontinued. Sorafenib was administered 7 days after discontinuation of sunitinib ; however, the patient experienced febrile neutropenia and rash, and sorafenib was discontinued. Extracorporeal partial nephrectomy and auto-transplantation were performed 24 days after discontinuation of sorafenib. Though peri-graft abscess was suspected to be present and resolved by antibacterial therapy, severe complications were not experienced, and the patient did not require dialysis therapy after surgery. There was no evidence of recurrence at 30 months after the surgery.
PDF
