Case report: neutropenic enterocolitis with cecal perforation in a breast cancer patient

Neutropenic enterocolitis with cecal perforation has been associated with the use of taxane-based chemotherapeutic agents, including docetaxel, which is used in managing cancers such as locally advanced or metastatic breast cancer. This report describes the case of a 52-year-old Saudi woman with left breast invasive ductal carcinoma and lymphovascular invasion, who presented with abdominal pain and febrile neutropenia after her first chemotherapy session. Initially treated conservatively with antibiotics, she returned 10 days later with severe abdominal pain. Imaging revealed a large lateral cecal wall defect and fecal peritonitis. She underwent an exploratory laparoscopic procedure, converted to laparotomy, during which a right hemicolectomy with double-barrel stoma creation was performed. Postoperative recovery was complicated by wound infection but improved with management. Following adjuvant therapies, including Herceptin and Pertuzumab, the stoma was reversed successfully. This case highlights the critical importance of early diagnosis and intervention in neutropenic enterocolitis to reduce morbidity and mortality.