Everolimus
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Abdominal lymphoedema: case report A 49-year old man developed abdominal lymphoedema during treatment with everolimus for renal cell carcinoma (RCC). The man was diagnosed with metastatic RCC in March 2014, following left nephrectomy. Initially, he was treated with sunitinib for pulmonary, pleural and bone metastases. After 9 months of therapy, he developed solitary cerebral metastases. As a result, therapy by neurosurgery and radiotherapy were performed. In January 2015, in order to control the progression of the disease, his treatment was switched to systemic therapy with everolimus 10 mg/day [route not stated]. His renal cancer remained stable, however in May 2015, a unilateral volume of the right part of the abdominal wall started increasing in the form of lymphoedema, emitting from the right axilla to the right inguinal. He experienced pain, oedema and uncomfortable stiffness of the abdominal wall. The abdominal asymmetry occurred only on the right side of the abdomen. Neither CT scan nor ultrasound detected ascites but showed enlargement of the abdominal wall. The lymphoedema progressed considerably over several days. The CT scan failed to reveal the actual cause of the development of unilateral abdominal oedema. The man was treated furosemide 40 mg/day and higher doses of dexamethasone 24 mg/day with no effect. However, discontinuation of everolimus therapy resulted in immediate alleviation and reduction of the oedema. However, everolimus was reinitiated at a reduced dose of 5 mg/day, but worsening of the lymphoedema was observed. The Naranjo Adverse Drug Reaction Probability Scale with a score of 6 indicated a probable adverse reaction to everolimus. Based on these findings and clinical presentation it was concluded that he developed abdominal lymphoedema associated with everolimus, which had significantly reduced his the quality of life [final outcome of ADR not stated]. Halamkova J, et al. Everolimus-related unilateral abdominal lymphedema in a renal cancer patient: A case report. Medicine 99: No. 42, 16 Oct 2020. Available from: URL: 803517312 http://doi.org/10.1097/MD.0000000000022634
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Reactions 28 Nov 2020 No. 1832
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