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Various toxicities: case report A 37-year-old man developed bilateral gynaecomastia, hyperprolactinaemia and male breast carcinoma during treatment with chlorpromazine for schizophrenia. Additionally, he developed thrombocytopenia during treatment with tamoxifen for male breast cancer [not all dosages, routes and outcomes stated; duration of treatment to reactions onset not stated]. The man developed left-sided tender breast swelling at the age of 14 years. His medical history was significant for two skull traumas during childhood. Subsequently, he received radiotherapy with X-irradiation. At the age of 16 years, one year postmutagenesis, he was hospitalised for fulminant schizophrenia. Therefore, he started receiving heavy dose of chlorpromazine. He received insulin coma and electroconvulsive treatment concomitantly. However, insufficient response was observed. Therefore, after 5 years post-mutagenesis, he underwent a frontal loboctomy. Chlorpromazine was continued, and he was hospitalised. At age of 37 years, he developed bilateral chlorpromazine-induced gynaecomastia, and the dominant lump was found to be on right hand side. Histopathology of the right dominant lump performed after the surgery confirms the gynaecomastia without atypia. After 2 years at the age of 39 years, the lump in the man’s left breast started to grow. Hence, mastectomy was performed. Histopathology of lump revealed two clearly separated foci of a poorly differentiated invasive ductal carcinoma. Four years later, a locoregional recurrence was observed without any distant metastases. Subsequently, an axillary lymph node was removed and cytology revealed metastatic growth of invasive ductal carcinoma. Radiotherpy was started. However, it was not possible to stop chlorpromazine during radiotherapy due to aggressive confusion. During the same period his prolactin levels were measured three times which were found to be 1007 mU/L, 1580 mU/L and 1058 mU/L. He was diagnosed with chlorpromazine-induced hyperprolactinaemia. Subsequently, the man started receiving tamoxifen 20mg daily [route not stated]. However, he developed thrombocytopenia associated with tamoxifen. After 18 months, the man stopped receiving tamoxifen, and thrombocytopenia was resolved. One year later, widespread metastases was observed. Chemotherapy and hormonal therapy was contraindicated, and four years later, he died without any anti-tumoral treatment [cause of death not stated]. Hultborn R, et al. Male Breast Carcinoma after Irradiation and Long-Term Phenothiazine Exposure: A Case Report. Case Reports in Oncology 13: 956-961, No. 2, 2020. 803520016 Available from: URL: http://doi.org/10.1159/000509074

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Reactions 12 Dec 2020 No. 1834