Pemetrexed-Associated Eyelid Edema: Effective Treatment by Excision of Lymphedematous Eyelid Tissue.
Identifieur interne : 001495 ( PubMed/Curation ); précédent : 001494; suivant : 001496Pemetrexed-Associated Eyelid Edema: Effective Treatment by Excision of Lymphedematous Eyelid Tissue.
Auteurs : Neeraj Mangla [États-Unis] ; Andrew Carlson ; Aida Wakil ; Nini Wu ; Edward J. WladisSource :
- Ophthalmic plastic and reconstructive surgery [ 1537-2677 ]
Descripteurs français
- KwdFr :
- Adénocarcinome (traitement médicamenteux), Antienzymes (effets indésirables), Femelle, Humains, Lymphoedème (), Lymphoedème (anatomopathologie), Maladies de la paupière (), Maladies de la paupière (anatomopathologie), Procédures de chirurgie ophtalmologique, Pémétrexed (effets indésirables), Sujet âgé, Tumeurs du poumon (traitement médicamenteux).
- MESH :
- anatomopathologie : Lymphoedème, Maladies de la paupière.
- effets indésirables : Antienzymes, Pémétrexed.
- traitement médicamenteux : Adénocarcinome, Tumeurs du poumon.
- Femelle, Humains, Lymphoedème, Maladies de la paupière, Procédures de chirurgie ophtalmologique, Sujet âgé.
English descriptors
- KwdEn :
- Adenocarcinoma (drug therapy), Aged, Enzyme Inhibitors (adverse effects), Eyelid Diseases (chemically induced), Eyelid Diseases (pathology), Eyelid Diseases (surgery), Female, Humans, Lung Neoplasms (drug therapy), Lymphedema (chemically induced), Lymphedema (pathology), Lymphedema (surgery), Ophthalmologic Surgical Procedures, Pemetrexed (adverse effects).
- MESH :
- chemical , adverse effects : Enzyme Inhibitors, Pemetrexed.
- chemically induced : Eyelid Diseases, Lymphedema.
- drug therapy : Adenocarcinoma, Lung Neoplasms.
- pathology : Eyelid Diseases, Lymphedema.
- surgery : Eyelid Diseases, Lymphedema.
- Aged, Female, Humans, Ophthalmologic Surgical Procedures.
Abstract
Pemetrexed is an antimetabolite agent that inhibits multiple folate-requiring enzymes and is used in the treatment of mesothelioma and non-small-cell lung cancer. One of its toxicities is isolated cutaneous swelling affecting the eyelids and/or orbit. The pathologic assessment or its management has not been addressed to date. Herein, the authors report a case of a 77-year-old woman treated with pemetrexed for non-small-cell lung adenocarcinoma who developed persistent, severe bilateral lower eyelid swelling for several months, despite compresses and oral diphenhydramine. Elective excision was performed with good results and no recurrence after 6 months' follow up. Histopathologically, the excised tissue showed changes typical of dermatochalasis with dissolution of collagen and elastic bundles and marked dilation of lymphatic vessels. The combination of pre-existing, localized lymphatic failure and capillary leakage secondary to pemetrexed therapy can explain the onset and worsening swelling with successive rounds of chemotherapy.
DOI: 10.1097/IOP.0000000000000186
PubMed: 24911536
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pubmed:24911536Le document en format XML
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<wicri:regionArea>*Department of Ophthalmology and †Department of Pathology, Albany Medical College; ‡New York Oncology-Hematology; and §Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany, New York</wicri:regionArea>
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<front><div type="abstract" xml:lang="en">Pemetrexed is an antimetabolite agent that inhibits multiple folate-requiring enzymes and is used in the treatment of mesothelioma and non-small-cell lung cancer. One of its toxicities is isolated cutaneous swelling affecting the eyelids and/or orbit. The pathologic assessment or its management has not been addressed to date. Herein, the authors report a case of a 77-year-old woman treated with pemetrexed for non-small-cell lung adenocarcinoma who developed persistent, severe bilateral lower eyelid swelling for several months, despite compresses and oral diphenhydramine. Elective excision was performed with good results and no recurrence after 6 months' follow up. Histopathologically, the excised tissue showed changes typical of dermatochalasis with dissolution of collagen and elastic bundles and marked dilation of lymphatic vessels. The combination of pre-existing, localized lymphatic failure and capillary leakage secondary to pemetrexed therapy can explain the onset and worsening swelling with successive rounds of chemotherapy.</div>
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