Penile-scrotal erythrodysesthesia among rectal cancer patients receiving fluoropyrimidine-based chemoradiation: a case report series

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2024年5月23日

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Angela Adames,
Diana Roth O’Brien,
Alison R. Kelly,
Leonard B. Saltz,
Julio Garcia-Aguilar,
Melissa Zinovoy,
Vonetta Williams,
Abraham Wu,
Marsha Reyngold,
Carla Hajj,
Christopher Crane,
Andrea Cercek,
J. Joshua Smith,
Alina Markova,
John Cuaron,
Patrick McCann,
Paul B. Romesser

摘要

Background

Palmar-plantar erythrodysesthesia (PPE) is a slowly developing cutaneous reaction commonly experienced by patients treated with fluoropyrimidines. While erythrodysesthesia normally presents in a palmar-plantar distribution, it can also present with genital involvement, but this presentation is likely underreported and incorrectly attributed to an acute reaction from radiation therapy. This article aims to define erythrodysesthesia of the penis and scrotum as a rare but significant side effect of capecitabine.

Case presentation

We identified five cases of moderate to severe penis and scrotal erythrodysesthesia over a 2-year period at a large tertiary cancer center, representing an estimated incidence of 3.6% among male patients with rectal cancer who were treated with fluoropyrimidine-based chemoradiation within our institution.

Conclusions

Improved understanding of erythrodysesthesia involving the penis and scrotum can facilitate early identification and treatment of symptoms, and possibly prevent the discontinuation or delay of cancer treatment in patients treated with capecitabine and similar drugs. These clinical advances would improve and prolong patient quality of life during cancer treatment and prevent complications that result in hospitalization.