Intravesically instilled gemcitabine-induced lung injury in a patient with invasive urothelial carcinoma: A case report  

作　　者：Xiao-Ming Zhou Cen Wu Xiu Gu 

机构地区：[1]Department of Respiratory and Critical Care Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,Liaoning Province,China [2]Department of Respiratory and Critical Care Medicine,Fourth Hospital of China Medical University,Shenyang 110004,Liaoning Province,China [3]Department of Pulmonary and Critical Care Medicine,Shengjing Hospital of China Medical University,Shenyang 110004,Liaoning Province,China

出　　处：《World Journal of Clinical Cases》2020年第19期4652-4659,共8页世界临床病例杂志

摘　　要：BACKGROUND Gemcitabine is a chemotherapy agent with relatively low toxicities,as a valid option for elderly patients with underlying diseases.Gemcitabine-induced pulmonary toxicities are rare and various,ranging from self-limited episodes of bronchospasm to fatal,progressive,severe,interstitial pneumonitis and respiratory failure.Intravesical gemcitabine instillations are commonly used to reduce recurrence or progression for non-muscle-invasive bladder cancer or urothelial cancer.Few severe toxicities have been reported for the intravesical instillation is assumed to be completely separated from the systemic circulation.CASE SUMMARY A 67-year-old patient received 30 cycles of intravesical gemcitabine instillation after transurethral resection and developed a 1-wk fever,cough,hemoptysis,and dyspnea.After a thorough checkup,bilateral consolidation and infiltration of the lungs were documented and a percutaneous lung biopsy confirmed organizing pneumonia after treatment with broad-spectrum empirical antibiotics failed.Tapered corticosteroids were administered,and pulmonary toxicity gradually resolved.CONCLUSION Gemcitabine-induced pulmonary toxicities present with various manifestations.In spite of the rare pulmonary involvement by the intravesical gemcitabine instillation,health care professionals who administer gemcitabine chemotherapy in this way should monitor for gemcitabine-induced pulmonary toxicities,particularly in patients with high-risk factors.

关 键 词：GEMCITABINE Interstitial lung disease Lung injury Organizing pneumonitis Urothelial carcinoma Case report Chemotherapy toxicity 

分 类 号：R737.1[医药卫生—肿瘤]