University Hospital Birmingham NHS Foundation Trust, Edgbaston, Birmingham, B15 2 TH, United Kingdom.
Sunitinib is an oral multi-targeted tyrosine kinase inhibitor which has shown efficacy in advanced renal cell carcinoma and represents a standard first line treatment for this disease.
Sunitinib is reasonably well tolerated, although dose adjustments are commonly required. Here we present a case of a patient with metastatic renal cancer and history of bipolar disorder who developed acute psychotic symptoms during treatment with Sunitinib.
Both the outpatient and inpatient documentation in the medical records of the patient were reviewed.
The patient developed symptoms of psychosis 3 days after hospital admission for sunitinib-related toxicity. Investigations excluded infection and brain metastases as potential causes for the symptoms. Acute psychosis did not respond to antipsychotic medication. Symptoms resolved with discontinuation of sunitinib.
The rare but potentially severe side effects of sunitinib should be borne in mind particularly in those patients with pre-existing medical conditions which could predispose them to life-threatening toxicities. Clinicians should stratify patients accordingly and consider alternative treatments where possible.
Copyright © 2011 Elsevier Inc. All rights reserved