Key result
Treatment with cisplatin and 5-fluorouracil was associated with the development of acute toxic myocardiopathy, aortic embolism, and fatal left cardiac failure in a patient with epidermoid carcinoma.
Case Report (n=1)
This case report highlights the risk of acute, fatal toxic myocardiopathy associated with 5-fluorouracil chemotherapy.
May warrant cardiotoxicity vigilance with cisplatin/5-FU; leaves open incidence and causality in larger cohorts.
This article presents a patient affected with epidermoid carcinoma of the soft palate who developed a dilated myocardiopathy with aortic embolism and fatal left cardiac failure after treatment with cisplatin (100 mg/m2, day 1) and 5-fluorouracil (1 g/m2/day i.v. days 2-6). The postmortem necropsy study showed diffuse interstitial edema and intracytoplasmic vacuolization of myocytes, without inflammatory changes. These findings were interpreted as acute toxic myocardiopathy, probably due to 5-fluorouracil treatment. Although the patient also received cisplatin, metoclopramide, allopurinol, thiethylperazine, and amitriptyline, before the onset of clinical symptoms, these drugs were not considered to play an important role in the production of this cardiopathy because of the dosage, necropsy findings, and lack of previous report.
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Martín et al. (1989) conducted a case report in Epidermoid carcinoma of the soft palate (n=1). Cisplatin and 5-fluorouracil was evaluated on Dilated myocardiopathy with aortic embolism and fatal left cardiac failure. Treatment with cisplatin and 5-fluorouracil was associated with the development of acute toxic myocardiopathy, aortic embolism, and fatal left cardiac failure in a patient with epidermoid carcinoma.
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