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Capecitabine-related intracranial hypotension syndrome mimicking dural metastasis in a breast cancer patient: case report and review of the literature.

Abstract
Spontaneous intracranial hypotension (SICH) is an entity, which is secondary to iatrogenic manipulation and breaching of dura. Postural headache in patients should be suspected, cranial magnetic resonance imaging (MRI) is essential for precise diagnosis. Hallmark of MRI is regular shape of pachymeningeal gadolinium enhancement and subdural effusion. It may mimic central nervous system (CNS) metastasis. Prevention of such cases from receiving cranial radiotherapy by misinterpretation of the gadolinium enhancement as CNS metastasis is an important issue. Capecitabine is an antineoplastic agent, of which metabolites can cross blood-brain barrier in CNS via epithelial tissue. It may cause decrease in CSF production. SICH might be the clinical reflection of this decrease in CSF production. Review of the English literature revealed limited data because of the very little experience with oncologic patients suffering from intracranial hypotension. We report a case of spontaneous intracranial hypotension during capecitabine treatment. Patient was completely well following drug discontinuation and supportive treatment.
AuthorsRusen Cosar-Alas, Aykan Alas, Alaattin Ozen, Bengu Denizli, Mert Saynak, Sernaz Uzunoglu, Nurettin Aydogdu, Hakan Karagol, Cem Uzal, Zafer Kocak
JournalJournal of cancer research and therapeutics (J Cancer Res Ther) 2010 Oct-Dec Vol. 6 Issue 4 Pg. 557-9 ISSN: 1998-4138 [Electronic] India
PMID21358101 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • Antineoplastic Agents
  • Deoxycytidine
  • Capecitabine
  • Fluorouracil
Topics
  • Antineoplastic Agents (adverse effects)
  • Breast Neoplasms (drug therapy, pathology)
  • Capecitabine
  • Deoxycytidine (adverse effects, analogs & derivatives)
  • Female
  • Fluorouracil (adverse effects, analogs & derivatives)
  • Humans
  • Intracranial Hypotension (chemically induced)
  • Middle Aged
  • Neoplasm Metastasis

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