Mesenteric Artery Dissection Aneurysm Associated with Apatinib in a Prostate Cancer Patient: A Case Report and Literature Review

前列腺癌患者服用阿帕替尼后发生肠系膜动脉夹层动脉瘤:病例报告及文献综述

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Abstract

BACKGROUND: Apatinib mesylate, a VEGFR2 tyrosine kinase inhibitor, is approved for advanced liver, esophageal, gastric and other malignant tumors, but its adverse effects require attention. We report a 79-year-old male with prostatic adenocarcinoma who developed superior mesenteric artery dissecting aneurysm after combined apatinib and chemotherapy. Apatinib, an anti-angiogenic agent, synergizes with chemotherapy. After informed consent, the combination regimen was initiated. Two cycles later, the patient had tolerable intermittent abdominal pain, and CT confirmed the aneurysm. Due to progressive tumor and poor physical status, no further treatment was given as the aneurysm did not affect the disease course. This case report aims to provide insights into the safe application of apatinib in clinical practice. MATERIALS AND METHODS: The materials for the literature review were gathered through a comprehensive search conducted on PubMed. Which yielded VEGFR2 treated for prostate cancer. CASE REPORT: In this case report, a 79-year-old male with a height of 172 cms and a weight of 67 kgs who had been diagnosed with prostate adenocarcinoma for over three years. MRI scan indicated that bone metastases increased and enlarged compared with prior test. No significant abnormalities were observed in both physical and blood examinations. The pelvic MRI scan showed a prostatectomy changes, multiple abnormal signals in the bilateral ilium, acetabulum, femur, ischiatic bone, pubis, sacral vertebrae, and part of the lumbar vertebrae. CONCLUSION: Antiangiogenic agents are being increasingly utilized in clinical practice. As clinicians, it is imperative to remain vigilant against potential complications such as arterial dissection and aneurysm, while conducting meticulous evaluations of associated risks. Notably, this article serves solely as a reference and does not advocate for the adjustment of treatment protocols on this basis.

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