Pazopanib
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Ischial skin necrosis: case report An approximately 31-year-old woman developed ischial skin necrosis during treatment with pazopanib for epithelioid sarcoma. The woman was diagnosed with epithelioid sarcoma at the age of 28 years. She was treated with chemotherapy using ifosfamide and piarubicin [tetrahydropyranyladriamycin] followed by surgery. However, after 9 months local recurrence was noted and after 17 months of surgery, lung metastases were observed. Subsequently, she underwent radiotherapy with embolization and for lung metastases, radiofrequency ablation was performed in combination with video-assisted thoracoscopic surgery. Despite treatment, her sarcoma grew subcutaneously. Therefore, after 3 years and 8 months after initial surgery, further treatment was started with pazopanib 800 mg/day [route not stated]. However, after initiating pazopanib, MRI studies showed massive tumor necrosis. Laboratory tests showed marked downregulation of CA125. Before treatment with pazopanib, serum CA125 level was 20,000 U/mL, which reduced to 136 U/mL after starting pazopanib. A diagnosis of ischial skin necrosis secondary to pazopanib was made. Additionally, ischial skin necrosis was also attributed to the necrosis of the underlying tumor. Ischial skin necrosis resulted in a large skin wound and necrosis of the subcutaneous soft tissue [duration of treatment to reaction onset not stated]. The woman’s pazopanib was stopped for 4 weeks and she underwent reconstructive surgery using a myocutaneous flap of the vastus lateralis under anaesthesia. Gradually the skin wound healed and no any complications occurred. After 2 months of surgery, the woman was re-started on pazopanib. However, due to persistent leucopenia, it was stopped. After 14 months of reconstructive surgery, she died of lung metastasis with extension of recurrent sarcoma into the pelvis. Tsujii M, et al. Vastus lateralis myocutaneous flap for ischial skin wound following the treatment of epithelioid sarcoma using pazopanib. Journal of Wound Care 29: 335-339, No. 6, 2 Jun 2020. Available from: URL: http://doi.org/10.12968/jowc.2020.29.6.335 803497955
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Reactions 22 Aug 2020 No. 1818
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