Aortobifemoral embolism in an 18-year old patient following cisplatin and 5-fluorouracil chemotherapy for nasopharyngeal carcinoma

After cisplatin/5-fluorouracil chemotherapy for nasopharyngeal carcinoma, an 18-year female patient developed aorto-bifemoral embolism. Besides chemotherapy, additional risk factors for arterial thromboembolic events were smoking, contraceptive medication and adjuvant antiemetic treatment with dexamethasone. Thrombophilia screening was negative. Thromboembolic complications during or after cisplatin have been reported in a frequency of 17.6% in lung cancer patients, and in 8.4% of patients with germ cell tumors. The incidence of arterial thromboembolic events was 9.3% and 1.7%, respectively. The pathogenesis of cisplatin induced thromboembolism is thought to be caused by endothelial damage leading to endothelial cell dysfunction, increased von Willebrand factor plasma levels, and hypomagnesaemia.