Clinical benefit of paclitaxel/carboplatin plus bevacizumab with zoledronic acid in pulmonary epithelioid hemangioendothelioma complicated by hypertrophic pulmonary osteoarthropathy and cardiac tamponade: a case report - Report - MDSpire
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Clinical benefit of paclitaxel/carboplatin plus bevacizumab with zoledronic acid in pulmonary epithelioid hemangioendothelioma complicated by hypertrophic pulmonary osteoarthropathy and cardiac tamponade: a case report
Efficacy of Paclitaxel/Carboplatin Combined with Bevacizumab and Zoledronic Acid
Overview
This case study reports the use of paclitaxel/carboplatin combined with bevacizumab and zoledronic acid in a 33-year-old woman with pulmonary epithelioid hemangioendothelioma (PEH) and hypertrophic pulmonary osteoarthropathy (HPOA). The treatment resulted in a marked reduction of effusions and improvement in symptoms, suggesting potential benefits of this combination therapy.
Background
Epithelioid hemangioendothelioma (EHE) is a rare vascular neoplasm with no standard systemic therapy, and pulmonary EHE (PEH) can be particularly aggressive. The association of PEH with hypertrophic pulmonary osteoarthropathy (HPOA) complicates management, as HPOA is often linked to malignancies and can significantly impact patient quality of life. Understanding effective treatment strategies for PEH is crucial given its poor prognosis when accompanied by serosal effusions.
Data Highlights
No numerical data or trial data were presented in the article.
Key Findings
The patient experienced chronic cough, arthralgia, and digital clubbing, indicative of PEH and HPOA.
Histopathology confirmed EHE with specific markers, including CD31 and CAMTA1 expression.
Paclitaxel/carboplatin plus bevacizumab was administered with palliative intent.
Follow-up imaging showed significant reduction in pericardial and pleural effusions.
Symptom improvement was noted in arthralgia and daily activities during treatment.
Concomitant zoledronic acid may have contributed to symptom relief associated with HPOA.
Clinical Implications
This case highlights the potential role of systemic chemotherapy combined with anti-VEGF therapy in managing advanced PEH. Clinicians should consider the use of bisphosphonates like zoledronic acid for symptom management in patients with HPOA associated with malignancies.
Conclusion
The findings from this case suggest that a combination of paclitaxel/carboplatin and bevacizumab, along with zoledronic acid, may provide temporary control of symptoms and effusions in advanced PEH. Further studies are warranted to explore this treatment approach in a broader patient population.
