Hand-foot syndrome related to liposomal doxorubicin.

137 K .M. was a 69-year-old woman who presented to her primary physician with bloating, abdominal cramping, and constipation over the previous weeks. She also noted some fullness in her right groin. She underwent an abdominal ultrasound, which revealed an adnexal mass on the right side of her abdomen, and a computed tomography (CT) scan, which demonstrated a large complex mass in the region of the right ovary along with fluid in the peritoneal cavity consistent with ascites. She had a cancer antigen 125 (CA-125) blood test for ovarian cancer drawn. The result was well above normal at 1,050 U/ml (normal range is up to 35 U/ml). Because of these findings, K.M. had a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and partial omentectomy performed, and the pathology showed a serous adenocarcinoma of the ovary. It was staged as IIIC ovarian cancer with involvement of right ovary, omentum, and peritoneal lymph nodes. The surgeon noted that she had an optimal cytoreduction of the cancer and, during the surgery, she had a peritoneal port-a-cath placed for future treatment with intraperitoneal chemotherapy. After approximately one month of healing, K.M. began treatment with a combination of intraperitoneal and IV chemotherapy with cisplatin and paclitaxel. She received six cycles of this treatment administered every three weeks. Unfortunately, within two months of completing her initial chemotherapy regimen, progression of her cancer was detected with an elevated CA-125 and an abdominal CT scan showing a new soft tissue mass adjacent to the spleen. K.M. began treatment with pegylated liposomal doxorubicin (Doxil®, Centocor Ortho Biotech, Inc.) at 50 mg/m2 IV every four weeks (the U.S. Food and Drug Administration [FDA]-approved dose for ovarian cancer). Doxil is doxorubicin encapsulated in a liposome, which increases the drug delivery and effectiveness and improves the adverse event profile comHand-Foot Syndrome Related to Liposomal Doxorubicin