A case of gastric perforation related to sunitinib after radiotherapy of spine in a patient with metastatic renal cell carcinoma

e13141 Background: Sunitinib is a multitarget tyrosine kinase inhibitor with antiangiogenic and antitumoral activities and has been approved for the treatment of advanced renal cell carcinoma. Although the general tolerance is acceptable, serious complications may occur in patients treated with sunitinib. Methods: In a forty-six-year-old man with metastatic renal cell carcinoma who was receiving sunitinib for 12 months, following radiotherapy of painful vertebral metastasis between T3 and L4, a duodenal ulcer perforation resulted with acute peritonitis. Favorable outcome was obtained after surgical intervention. Since there was no therapeutic alternative and also good initial response to sunitinib, the patient continued sunitinib at a lower dose (37.5 mg/d). One year after this episode, the patient presented a fatal upper gastrointestinal bleeding. Results: Two cases of intestinal perforation in renal cancer have been reported in the literature, but no case of gastric perforation. We think that this event...