Cytotoxic Lesion of the Corpus Callosum Associated with 5-Fluorouracil: A Case Report and Review of Literature


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MILDANOĞLU M. M., KARAALİOĞLU B., Engi̇N Deli̇Poyraz E., YÜCEL M. H., Ölmez Ö. F.

Journal of Oncological Science, cilt.11, sa.2, ss.179-181, 2025 (Scopus, TRDizin)

Özet

Cytotoxic lesions of the corpus callosum (CLOCC) represent a rare neurological complication. 5-fluorouracil (5-FU) has been associated with CLOCC; however, its precise pathophysiology remains poorly understood. We present the case of a 64-year-old woman with recurrent head and neck squamous cell carcinoma who developed CLOCC following treatment with a regimen including 5-FU, carboplatin, cetuximab, and pembrolizumab. The patient had previously undergone surgery and adjuvant chemoradiotherapy, but later progressed to metastatic disease. After initiating 5-FU-based chemotherapy, she developed neurological symptoms. Diffusion-weighted magnetic resonance imaging revealed cytotoxic lesions in the splenium of the corpus callosum, consistent with CLOCC. Despite discontinuation of chemotherapy and administration of corticosteroids, the patient’s condition deteriorated, and she ultimately died due to severe pneumonia and septic shock. This case underscores the rare yet serious risk of CLOCC in patients receiving 5-FU. Further research is needed to elucidate the underlying mechanisms and to identify risk factors associated with 5-FU-related neurotoxicity.