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Bowel Perforation Following Continuation of Bevacizumab Post Nasal Septal Perforation―A Case Report

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DOI: 10.4236/crcm.2014.35070    2,813 Downloads   3,626 Views  


We report the case of a 63-year-old male with an inoperableT4N1 adenocarcinoma of colon, K-RAS mutant, who received first line chemotherapy with capecitabine and oxaliplatin. A CT scan following 4 cycles demonstrated progressive disease, and second line therapy with capecitabine, irinotecan and bevacizumab was commenced. CT scans at 3 and 6 months during this treatment regime demonstrated radiologically stable disease, and therefore the treatment was continued. The patient developed nasal septal perforation, a rare but recognised complication of bevacizumab therapy, which was managed conservatively. Here we highlight that no consensus exists on whether bevacizumab should be continued in this situation. After a detailed discussion about the risks and benefits, this patient continued on with the same therapeutic regime. However, eight weeks later, this patient then developed a localised tumour perforation, necessitating an emergency admission to his local hospital. We recommend caution in continuing bevacizumab in patients with colorectal cancer following a nasal septal perforation and advise a detailed discussion of risk with the patient, especially when the primary tumour remains in-situ.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Nelmes, D. and Gwynne, S. (2014) Bowel Perforation Following Continuation of Bevacizumab Post Nasal Septal Perforation―A Case Report. Case Reports in Clinical Medicine, 3, 319-321. doi: 10.4236/crcm.2014.35070.


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