Cancer Research and Treatment  2011;43(4):260-263

Fatal Ifosfamide-Induced Metabolic Encephalopathy in Patients with Recurrent Epithelial Ovarian Cancer: Report of Two Cases.

You Jung SHIN 1 ; Ji Young KIM ; Jei Won MOON ; Rae Mi YOU ; Jeong Yeol PARK ; Joo Hyun NAM

Affiliations

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Keywords

Encephalopathy; Ovarian epithelial cancer; Ifosfamide; Mesna; Methylene blue

Country

Republic of Korea

Language

English

Abstract

Central nervous system (CNS) toxicity has been reported in approximately 10-30% of patients receiving intravenous infusions of ifosfamide. Encephalopathy is a rare but serious CNS adverse reaction in these patients, and although usually transient and reversible, may cause persistent neurological dysfunction or death. Clinical features range from fatigue and confusion to coma and death. Although methylene blue can be used to treat ifosfamide-induced neurotoxicity, including encephalopathy, its mechanism of action remains poorly defined. We describe here two patients with recurrent epithelial ovarian cancer who experienced fatal encephalopathy following ifosfamide/mesna treatment.