The standard adjuvant treatment of colon cancer is fluorouracil plus leucovorin. Oxaliplatin improves the ef-ficacy of this combination in patients with stage Ⅲ colon cancer and moreover its toxicity is well tolerable. We de-scribe a rare clinical case of acute dyspnoea probably re-lated to oxaliplatin at one month from the end of the ad-juvant treatment. A 74-year-old man developed a locally advanced sigmoid carcinoma (pT3N1M0). A port a cath attached to an open-ended catheter was implanted in order to administer primary chemotherapy safely according to the FOLFOX4 schedule. One month following the end of the 6th cycle, the patient referred a persistent cough and moderate dyspnoea. Chest radiography displayed a change in the lung interstitium, chest CT scan con-firmed this aspect of adult respiratory distress syndrome, spirometry reported a decreased carbon monoxide diffu-sion capacity. Antibiotic and corticosteroids were admin-istered for 10 d, then a repeated chest X ray evidenced a progressive pulmonary infiltration. A transbronchial biopsy and cytology did not show an infective process, a CT scan reported radiological abnormalities including linear and nodular densities which were becoming con-fluents. Antimicotic and antiviral drugs did not evidence any benefit. The antiviral therapy was stopped and high dose metilprednisolone was started. The patient died of pulmonary distress after 10 d.
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