内容紹介
A Case of Cystoid Macular Edema Secondary to Albumin-Bound Paclitaxel Therapy
Summary
A 73-year-old woman diagnosed with unresectable pancreatic cancer received weekly gemcitabine(GEM)plus albumin-bound paclitaxel(nab-PTX)therapy. Four months after nab-PTX therapy was initiated, she presented with a rapidly decreasing vision in her left eye at an ophthalmology clinic. On admission, her visual acuity was decreased, and optical coherence tomography(OCT)revealed a cystoid macular edema(CME)only in her left eye. She discontinued the nab-PTX therapy immediately. Her visual acuity improved on follow-up 6 months later. The CME finding on OCT was reduced but not completely resolved. CME is a rare adverse event induced by nab-PTX therapy, with only 14 cases reported since 2008. In most of the reported cases, the patients had breast cancer, and this is the first reported case of CME in a patient with pancreatic cancer. The time to CME onset from starting nab-PTX therapy was reported to range from 3 to 30 months, but the predilection time has not been clarified. Many reports indicated that symptoms improved in a short period after discontinuation of nab-PTX therapy, but effective treatment was not established, except discontinuation of nab-PTX therapy. In daily medical treatment, the incongruity of the ophthalmologic domain should be confirmed for early detection of CME.
要旨
症例は73歳,女性。膵頭部癌stageⅣbで根治切除不能と診断され,ゲムシタビン(GEM)+アルブミン懸濁型パクリタキセル(ナブ・パクリタキセル: アブラキサン®: nab-PTX)療法を開始した。GEM+nab-PTX療法開始から4か月後に視力低下を指摘され,光干渉断層計(optical coherence tomography: OCT)で左眼の嚢胞様黄斑浮腫(cystoid macular edema: CME)と診断された。CME発症後は速やかにnab-PTX投与を中止し,発症6か月後に左眼視力は回復したが,OCTではCMEは縮小し残存していた。nab-PTXによるCMEはまれな副作用であり本症例を含め14例が報告されているが,膵癌症例での報告は本例が初めてであった。日々の診療時に視力低下など眼科領域に関する違和感の有無を継続的に確認することが,CMEの早期発見には重要であると思われた。
目次
Summary
A 73-year-old woman diagnosed with unresectable pancreatic cancer received weekly gemcitabine(GEM)plus albumin-bound paclitaxel(nab-PTX)therapy. Four months after nab-PTX therapy was initiated, she presented with a rapidly decreasing vision in her left eye at an ophthalmology clinic. On admission, her visual acuity was decreased, and optical coherence tomography(OCT)revealed a cystoid macular edema(CME)only in her left eye. She discontinued the nab-PTX therapy immediately. Her visual acuity improved on follow-up 6 months later. The CME finding on OCT was reduced but not completely resolved. CME is a rare adverse event induced by nab-PTX therapy, with only 14 cases reported since 2008. In most of the reported cases, the patients had breast cancer, and this is the first reported case of CME in a patient with pancreatic cancer. The time to CME onset from starting nab-PTX therapy was reported to range from 3 to 30 months, but the predilection time has not been clarified. Many reports indicated that symptoms improved in a short period after discontinuation of nab-PTX therapy, but effective treatment was not established, except discontinuation of nab-PTX therapy. In daily medical treatment, the incongruity of the ophthalmologic domain should be confirmed for early detection of CME.
要旨
症例は73歳,女性。膵頭部癌stageⅣbで根治切除不能と診断され,ゲムシタビン(GEM)+アルブミン懸濁型パクリタキセル(ナブ・パクリタキセル: アブラキサン®: nab-PTX)療法を開始した。GEM+nab-PTX療法開始から4か月後に視力低下を指摘され,光干渉断層計(optical coherence tomography: OCT)で左眼の嚢胞様黄斑浮腫(cystoid macular edema: CME)と診断された。CME発症後は速やかにnab-PTX投与を中止し,発症6か月後に左眼視力は回復したが,OCTではCMEは縮小し残存していた。nab-PTXによるCMEはまれな副作用であり本症例を含め14例が報告されているが,膵癌症例での報告は本例が初めてであった。日々の診療時に視力低下など眼科領域に関する違和感の有無を継続的に確認することが,CMEの早期発見には重要であると思われた。