IMR Press / EJGO / Volume 38 / Issue 6 / 10.12892/ejgo3863.2017

European Journal of Gynaecological Oncology (EJGO) is published by IMR Press from Volume 40 Issue 1 (2019). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Open Access Case Report
A case of pseudomembranous colitis associated with paclitaxel and carboplatin chemotherapy for vulvar cancer
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1 Department of Medical Oncology, University Hospital of Larissa, Larissa, Greece
2 Department of Evangelismos, General Hospital of Athens, Athens, Greece
Eur. J. Gynaecol. Oncol. 2017, 38(6), 985–987;
Published: 10 December 2017
Abstract

Introduction: Pseudomembranous colitis is inflammatory disease of the colon with symptoms that may range from loose stool in the mildest cases to toxic megacolon (fever, nausea, vomiting, and ileus) and colonic perforation (rigid abdomen and rebound tenderness) in the most severe cases. In the last decades the causative relationship of cytotoxic and targeted antineoplastic agents with pseudomembranous colitis is increasingly recognized among cancer patients. Material and Methods: Here in the authors present a case of metastatic squamous vulvar cancer that developed pseudomembranous colitis after treatment with the combination of chemotherapy (paclitaxel and carboplatin). Results: The actual rate of paclitaxel-containing chemotherapy induces pseudomembranous colitis is not simple to determine and probably underestimated, as most relevant studies were conducted on a small scale. Methotrexate, cisplatin, cleomycin are the most common agents associated Clostridium difficile infection. Pseudomembranous colitis, whatever the chemotherapy usually appears soon after its administration, with watery stool that soon becomes bloody and affects almost equally men and women with a mean age of 58.64 years. Conclusions: Combination or single-agent chemotherapy are associated with pseudomembranous colitis. Clinicians need to have a high index of suspicion and the combination of the clinical picture with the characteristic findings on a colonoscopy and stool cultures can help in the prompt diagnosis. Pseudomembranous colitis can be reversible with appropriate supportive treatment and discontinuation of the causative factors.
Keywords
Pseudomembranous colitis
Stool culture
Colonoscopy
Diarrhea
Chemotherapy
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