Gemcitabine

Abstract

Posterior reversible encephalopathy syndrome: case report A 60-year-old woman developed posterior reversible encephalopathy syndrome (PRES) during treatment with gemcitabine for metastatic breast cancer. The woman, who had a history of invasive ductal carcinoma of the left breast, presented with mild complaints of lightheadedness. She had received multiple unspecified treatments with a continued progressive disease. Further investigations revealed metastatic liver lesion and a triple-negative invasive ductal breast cancer. She was treated with IV gemcitabine 1 g/m2 on days 1 and 8 for every three weeks of each cycle. Three weeks after completion of the third cycle, she developed new onset lightheadedness. A brain MRI was unremarkable. She presented with a bilateral vision loss after one week, and she was immediately admitted to the emergency department. She then underwent an emergent brain imaging, which showed increased intravascular leptomeningeal enhancement and bilateral parieto-occipital lobe vasogenic oedema with hyperintense signal. Due to generalised tonic-clonic seizure activity, she was intubated and sedated. Based on all the findings, PRES secondary to gemcitabine was diagnosed. The woman was treated with unspecified anticonvulsant therapy with a continuous BP monitoring, and gemcitabine was stopped. A significant improvement in her neurological function was noted. After 7 days, she was extubated and underwent a brain MRI that revealed improved findings in the occipital and parietal lobes. After 12 days, she was discharged and was scheduled for a routine follow-up. Thereafter, her condition completely recovered, and she received an alternate chemotherapy for metastatic cancer.