Original articles
A Case of Nasal Mucosal Adhesions in a Patient Treated with Bevacizumab
2022 Volume 115 Issue 7 Pages 601-606
Details
2022 Volume 115 Issue 7 Pages 601-606
Bevacizumab is a molecular-targeted agent that targets vascular endothelial growth factor and is used in the treatment of some types of cancers. Rare cases of nasal septal perforation occurring after bevacizumab therapy have been reported. Herein, we report a case of nasal mucosal adhesions that developed after bevacizumab administration.
The patient was a 62-year-old woman with ovarian cancer, who had received treatment with TCB (paclitaxel, carboplatin and bevacizumab) two years ago. She was referred to our hospital complaining of nasal obstruction. Examination revealed nasal mucosal adhesions; the mucosa lining the inferior turbinates on either side was adherent to the mucosa lining the nasal septum. No perforation of the nasal septum was recognized. Laboratory examination revealed negative test results for markers of ANCA-associated vasculitis, infectious disease, and autoimmune disease. The patient had no previous history of nasal operation or trauma. We dissected the adhesions and obtained biopsy specimens from the nasal mucosa under general anesthesia for the purpose of diagnosis and appropriate treatment.
Silicon seats were placed in the nasal cavity and the patient was administered tranilast and steroid collunarium after the operation to prevent readhesion. Biopsy revealed vascular hyperplasia and an abundant fibrous stroma.
There has been increased in the number of reports of nasal perforation in patients treatment with bevacizumab recently. An observational study of the findings in the nose after chemotherapy and bevacizumab in 47 cancer patients (including colon cancer, ovarian cancer, breast cancer, lung cancer, renal cancer, and cervical cancer) revealed some abnormal findings in 96%, color change in 57%, erosions in 30%, and perforation in 2% of the patients. There are no reports to date of nasal adhesions developing after bevacizumab administration, but we believe that the nasal mucosal adhesions in our case could have been caused by bevacizumab.
