Colonic pneumatosis and intestinal perforations with sunitinib treatment for renal cell carcinoma

Excerpt

A woman with renal cell carcinoma (RCC) presented with sudden right sided flank pain and anuria. Two years earlier she was diagnosed with RCC clear cell type and had a left-sided nephrectomy performed at that time. Her initial staging evaluation revealed multiple pulmonary nodules consistent with metastatic disease and she was started on sorafenib therapy. She remained on this therapy for 9 months, but was then found to have progressive disease and high-dose interleukin-2 (IL2) was initiated. The patient developed bilateral pulmonary edema during her initial course of IL2 which was believed to be secondary to IL2-induced capillary leak and required endotracheal intubation. Accordingly, IL2 was abandoned without completing a full course and treatment with sunitinib (50 mg daily for 4 weeks followed by a 2 week break) was pursued. …