A Case of Nonocclusive Mesenteric Ischemia During Bioradiotherapy With Cetuximab

TL;DR

A 73-year-old man developed nonocclusive mesenteric ischemia during bioradiotherapy with cetuximab, leading to intestinal necrosis and death.

Contribution

Reports a novel case linking bioradiotherapy with cetuximab to nonocclusive mesenteric ischemia.

Findings

Patient developed NOMI during cetuximab-based bioradiotherapy.

NOMI was confirmed by CT scan showing mesenteric ischemia and intestinal emphysema.

Patient succumbed to septic shock despite treatment.

Abstract

Nonocclusive mesenteric ischemia (NOMI) causes mesenteric ischemia and intestinal necrosis despite the absence of organic obstruction, such as thrombi and emboli in mesenteric blood vessels, and it has an extremely poor prognosis. We report a case of NOMI developed during bioradiotherapy (BRT) with cetuximab for cervical lymph node metastasis of tongue cancer. The patient was a 73-year-old man who underwent right radical neck dissection for neck lymph node metastasis after tongue cancer surgery. Postoperatively, the patient received BRT with cetuximab. On the 34th day after BRT, the patient had abdominal distension and a decreased level of consciousness. Contrast-enhanced computed tomography revealed mesenteric ischemia without thrombi and extensive intestinal emphysema. The patient was diagnosed with NOMI. Furthermore, he had septic shock and was treated with vasopressors and antibacterial agents; however, the condition of the patient did not improve, and he died on the same day.

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