Bülent KANTARÇEKENE, Ali ÇETİNKAYA, Nurhan ATİLLA, Eren Canan DAĞLI, Emin Mehmet GELEN, Çetin TANRIKULU, Nurhan KÖKSAL

Oddi sphincter fibrosis due to chemotherapy agents in small cell lung cancer: Case report

Altmış iki yaşında erkek hastaya küçük hücreli akciğer kanser tanısı koyuldu. Sisplatin (80 mg/m2) birinci gün ve etoposid (100 mg/m2) ikinci ve üçüncü gün olmak üzere kemoterapi protokolü (21 günde bir) başlandı. Hasta 3. kürünü aldıktan sonra, sarılık ve hiperbilirubinemi saptandı. Hepatik ultrasonografide koledok ve intrahepatik biliyer kanalda dilatasyon izlendi. Viral hepatit açısından serolojik ve biyokimyasal testler normal bulundu. Endoskopik retrograd kolanjiyopankreatografi (ERCP) yapıldı. İlk ERCP’de endoskopik sfinkterotomi yapıldı, iki gün sonra ikinci ERCP’de oddi sfinkteri fibrotik ve stenotik izlendi ve stent yerleştirildi. Stent takıldıktan bir gün sonra direkt bilirubin 6.2 mg/dL saptandı ve 10 gün sonra laboratuvar parametreleri normal izlendi. Akciğer kanserinde sisplatin ve etoposid kemoterapisi esnasında gelişen oddi sfinkter fibrozis olgusu bildirilmediği için ilginç bir olgu olarak sunulmuştur.

Küçük hücreli akciğer kanseri olgusunda kemoterapiye bağlı gelişen oddi sfinkter fibrozis

A 62-year-old, man patient was diagnosed as small cell lung cancer. Cisplatin (80 mg/m2, first day) and etoposide (100 mg/m2, three days) chemotherapy was started for once 21 days. As the patient received third course of chemotherapy, jaundice and hyperbilirubinemia were detected. Hepatic ultrasonography showed dilated choledochus and intrahepatic biliary tract. Hepatic markers and serologic tests for viral hepatitis were found as normal. Finally endoscopic retrograde cholangiopancreatography (ERCP) was performed. Endoscopic sphincterotomy was performed in the first ERCP and two days later, second ERCP was performed and oddi sphincter was seen as fibrotic and stenotic and stent was placed. One day after the stent placement, direct bilirubin was found as 6.2 mg/dL and 10 days later laboratory parameters were detected as normal. Oddi sphincter fibrosis occurred due to lung cancer chemotherapy treatment is an interesting case for fibrosis not having been reported due to cisplatin or etoposide before.

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