[A Patient with Lung Cancer Experiencing Abdominal Aortic Aneurysm Rupture during Bevacizumab Treatment-Case Report]

Right pleural effusion was detected on chest X-ray performed prior to surgery for a right inguinal hernia in a 63-yearold man. Adenocarcinoma was diagnosed based on pleural effusion cytology results. A CT scan revealed mediastinal lymphadenopathy and pleural dissemination, but no obvious lung tumor; other examinations also did not reveal a primary tumor. We, therefore, diagnosed primary lung cancer(c-TxN2M1a, Stage ⅣA, according to the General Rules for Clinical and Pathological Record of Lung Cancer, 8th edition). An abdominal aortic aneurysm was also observed on CT. Since he was diagnosed with EGFR-negative lung cancer with malignant pleural effusion, we selected chemotherapy with cisplatin, pemetrexed, and bevacizumab(CDDP/PEM/Bev)and administered 2 courses without problems. He experienced no adverse events during the 3rd course and was discharged on day 8. However, he was transported to our emergency room at 20: 45 on treatment day 10 when he developed abdominal pain and nearly fainted. An abdominal aortic rupture was diagnosed by CT, and he was transported to another hospital because he could not be treated at our hospital. Information that this patient had been treated with Bev was not provided to the doctor on duty, and abdominal aortic graft replacement was immediately performed. The patient had a good postoperative course without anastomotic leakage and was discharged on day 7 after surgery. Bev is a monoclonal antibody for vascular endothelial growth factor.

We report that this drug, bevacizumab, may be associated with abdominal aortic rupture.