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Unexpected outcome (positive or negative) including adverse drug reactions
CASE REPORT
Visual deficit possibly caused by lutetium-177 PSMA treatment
  1. Ludwike van Kalmthout1,
  2. Anine Stam2,
  3. Renze Gans3,
  4. Marnix Lam1
  1. 1Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to Ludwike van Kalmthout, L.W.M.vanKalmthout-2{at}umcutrecht.nl

Summary

This report describes a case of a 54-year-old man who underwent lutetium-177-PSMA therapy in the setting of metastatic castration-resistant prostate cancer (mCRPC) in the University Medical Center Utrecht. Following administration of the second cycle, patient presented with a slowly impairing, bilateral visual loss. This clinical presentation was most likely the result of the high intracranial pressure due to impediment of cerebrospinal fluid circulation, possibly related to obstructive dural thickness, being either caused by dural and/or leptomeningeal metastases of advanced mCRPC or by local radiation effects following lutetium-177-PSMA therapy. Describing this case, we aim to add to the discussion on 177Lu-PSMA safety, in which prospective research will ultimately offer definite answers.

  • unwanted effects / adverse reactions
  • prostate cancer

https://doi.org/10.1136/bcr-2018-225508

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    Footnotes

    • Contributors LvanK: has made substantial contributions to conception and design of the manuscript and has been involved in drafting and revising the manuscript. AS, RG: has been involved in the clinical care of the patient during hospital admission and has made substantial contributions to conception and design of the manuscript and has been involved in revising it critically for important intellectual content. ML: initiated this paper and has been involved in the clinical care of the patient during hospital admission. Also he has made substantial contributions to revision of the manuscript. All authors have contributed significantly to this paper, and also approved the content of the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Next of kin consent obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.