Unusual case of colorectal carcinoma with sarcoid-like mediastinal adenopathy and near-fatal DPD deficiency

SA Journal of Oncology


 
 
Field Value
 
Title Unusual case of colorectal carcinoma with sarcoid-like mediastinal adenopathy and near-fatal DPD deficiency
 
Creator Pillay, Shakti Terreblanche, Owen Devar, John Wadee, Ashraf
 
Subject — colon cancer; FOLFOX; dihydropyrimidine dehydrogenase deficiency; chemotherapy; metastatic diseas
Description The liver is the commonest site for metastases in colorectal carcinoma; other isolated sites are considered extremely rare. 5-fluorouracil (5-FU) is the backbone of treatment for metastatic colorectal carcinoma (mCRC) and without it survival may be significantly reduced. It is primarily metabolised by dihydropyrimidine dehydrogenase (DPD). Testing for DPD deficiency is not a routine practice and toxicity will only manifest following drug challenge. There are limited standardised treatment guidelines in managing patients with severe drug reactions following 5-FU exposure. We describe a delayed presentation of life-threatening DPD deficiency in a patient with colorectal carcinoma and mediastinal lymphadenopathy. We describe our experience with chemotherapy in this difficult clinical scenario and highlight the importance of histological confirmation in unusual sites of metastatic disease.
 
Publisher AOSIS
 
Contributor
Date 2021-03-12
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajo.v5i0.160
 
Source South African Journal of Oncology; Vol 5 (2021); 4 pages 2523-0646 2518-8704
 
Language eng
 
Relation https://sajo.org.za/index.php/sajo/article/view/160/459 https://sajo.org.za/index.php/sajo/article/view/160/458 https://sajo.org.za/index.php/sajo/article/view/160/460 https://sajo.org.za/index.php/sajo/article/view/160/457
 
Coverage — — —
Rights Copyright (c) 2021 Shakti Pillay, Owen Terreblanche, John Devar, Ashraf Wadee https://creativecommons.org/licenses/by/4.0