PRES, the Most Uncommon Side Effect of One of the Commonest Chemotherapy Regimen, FOLFOX

Abstract

Introduction: Posterior reversible encephalopathy syndrome (PRES), is a syndrome characterized by headache, confusion, seizures and visual loss, which was first described in 1996 by Judy Hinchey. The cause of PRES is not yet understood. We report a case of a 50-year-old man that developed PRES after the use of mFOLFOX 6 (Oxaliplatin/5-Fluoracil/Leucovorin) chemotherapy for colorectal cancer.Case report: An adult patient of colorectal cancer underwent resection of the primary tumor followed by adjuvant chemotherapy with mFOLFOX 6. Five days after the eleventh cycle he presented with headache and ataxia. A brain MRI (FLAIR/T2) was performed the same day which showed an increase of signal in both cerebellar lobes. Diagnosis of PRES was made by the radiologist. His symptoms started to improve after 3 days of hospitalization, and he was discharged after five days of hospital stay. A repeat MRI after 2 weeks revealed complete resolution of the hyper intense lesions in bilateral cerebellar lobes. Conclusion:Oncologists must be aware of this uncommon but specific adverse effect of FOLFOX chemotherapy, as prompt diagnosis may result in complete resolution of PRES.