Skip to main content

Advertisement

Log in

Simultaneous chylous ascites and chylothorax during ramucirumab plus docetaxel chemotherapy in a patient with non-small lung cell cancer

  • Case report
  • Published:
International Cancer Conference Journal Aims and scope Submit manuscript

Abstract

A 69-year-old woman was diagnosed as having non-small cell lung cancer (adenocarcinoma, T1aN3M1b). She had no history of surgery or abdominal trauma. She was treated with ramucirumab (10 mg/kg) plus docetaxel (60 mg/m2) intravenously (RAM + DTX) every 3 weeks. Although an enhanced CT examination showed a partial tumor response after eight courses of RAM + DTX, she gradually began to experience abdominal fullness with severe peripheral pitching edema. Her body weight increased by 18 kg in 2 months and RAM + DTX chemotherapy was discontinued. An enhanced CT examination showed a large amount of ascites and pleural effusion, with no obstructions of the central vein or lymphatic ducts. The ascites were white and milky in appearance and contained 527 mg/dL of triglyceride. In addition, her pleural effusion was also white and milky in appearance. No further increases in ascites and pleural effusion were observed thereafter. Four months after her last RAM + DTX chemotherapy, she continued to exhibit a partial response and no increases in ascites or pleural effusion were present. The chylous effusion might have been caused by the RAM + DTX chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Abbreviations

NSCLC:

Non-small cell lung cancer

RAM:

Ramucirumab

DTX:

Docetaxel

VEGFR:

Vascular endothelial growth factor receptor

LECs:

Lymphatic endothelial cells

References

  1. Arnold D, Fuchs CS, Tabernero J et al (2017) Meta-analysis of individual patient safety data from six randomized, placebo-controlled trials with the antiangiogenic VEGFR2-binding monoclonal antibody ramucirumab. Ann Oncol 28(12):2932–2942

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Spratlin J, Cohen R, Eadens M et al (2010) Phase I pharmacologic and biologic study of ramucirumab (IMC-1121B), a fully human immunoglobulin G1 monoclonal antibody targeting the vascular endothelial growth factor receptor-2. J Clin Oncol 28(5):780–787

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Lizaola B, Bonder A, Trivedi HD et al (2017) Review article: the diagnostic approach and current management of chylous ascites. Aliment Pharmacol Ther 46(9):816–824

    Article  CAS  PubMed  Google Scholar 

  4. Dellinger MT, Meadows SM, Wynne K, Cleaver O, Brekken RA (2013) Vascular endothelial growth factor receptor-2 promotes the development of the lymphatic vasculature. PLoS One 8(9):e74686

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Norgall S, Papoutsi M, Rössler J et al (2007) Elevated expression of VEGFR-3 in lymphatic endothelial cells from lymphangiomas. BMC Cancer 7:105

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Shimizu Y, Kanamaru S, Ito N (2015) Simultaneous chylothorax and chylous ascites in a patient with castration-resistant prostate cancer after docetaxel chemotherapy: an unusual manifestation. Int J Urol 22(6):614

    Article  PubMed  Google Scholar 

  7. Nakagiri T, Tokunaga T, Kunoh H et al (2018) Surgical treatment following chemo-targeted therapy with bevacizumab for lung metastasis from colorectal carcinoma: analysis of safety and histological therapeutic effects in patients treated at a single institution. Case Rep Oncol 11(1):98–108

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Makoto Arai.

Ethics declarations

Conflict of interest

There is no competing interest.

Ethical statement

In Chiba University hospital, we announce that clinical studies are performed in this hospital and that their results are published. We explained her and got the written informed consent in accordance with the Declaration of Helsinki.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arai, M., Maruta, S., Fan, M.M. et al. Simultaneous chylous ascites and chylothorax during ramucirumab plus docetaxel chemotherapy in a patient with non-small lung cell cancer. Int Canc Conf J 8, 114–117 (2019). https://doi.org/10.1007/s13691-019-00366-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13691-019-00366-6

Keywords

Navigation