Colonic Perforation Associated with Necrotizing Fasciitis in a Patient Receiving Tyrosine Kinase Inhibitor (Pazopanib) for Recurrent Retroperitoneal Renal Cell Carcinoma

Arda Akoluk, Steven Douedi, Jaraad Dattadeen, Victoria Grille, Esther Kaufman, Edward Liu, Glenn Parker, Kenneth Nahum

Abstract


Pazopanib, under the trade name of votrient, is a potent tyrosine-kinase growth factor receptor inhibitor used in the treatment of late-stage kidney cancer and soft tissue sarcoma. Rarely this drug has been associated with gastrointestinal perforations; however, prior studies have not shown an association with necrotizing fasciitis. We present a case of suspected pazopanib-induced extensive colonic perforation resulting in a severe necrotizing fasciitis. As this is a potentially rare complication of this targeted therapy, our goal is to heighten the awareness of colonic perforation as it is only seen in 0.9% of patients on pazopanib. The staged operative management and multidisciplinary approach throughout this patient’s care allowed for complete recovery from a life-threatening diagnosis.




J Curr Surg. 2020;10(3):54-58
doi: https://doi.org/10.14740/jcs416

Keywords


Necrotizing fasciitis; Pazopanib; Colon; Perforation; Gastrointestinal; Kidney; Cancer

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