Abstract
A 63-year-old man with nasopharyngeal cancer and right supraclavicular lymph nodes recurrence received cetuximab and radiation therapy. A follow-up computed tomography (CT) scan after 2 cycles revealed free air and diffuse intramural air in the small intestine. There were no apparent findings suggestive of intestinal necrosis or gastrointestinal perforation. The patient's condition improved through conservative therapy including withdrawal of cetuximab. A follow-up CT scan 7 days later showed complete resolution of free air and diffuse intramural air in the small intestine. Recently, pneumatosis cystoides intestinalis caused by cetuximab has been reported. We consider that cetuximab might have induced pneumatosis cystoides intestinalis in this case. Abrupt elevation of the inner pressure in the intestine due to constipation might have caused a rupture of the emphysema, resulting in free air.
