American Journal of Cancer Prevention, 2015, Vol. 3, No. 4, 74-76 Available online at http://pubs.sciepub.com/ajcp/3/4/2 © Science and Education Publishing DOI:10.12691/ajcp-3-4-2 Gemcitabine and Cisplatin Induced Reversible Posterior Leukoencephalopathy Syndrome: A Case Report Erkan Dogan 1,* , Cemile Ayse Gormeli 2 , Mehmet Fatih Ozbay 3 , Edip Gonullu 4 , Alper Can 5 , Harun Arslan 6 1 Department of Medical Oncology, Yuzuncu Yil University Medical Faculty, Van,Turkey 2 Department of Radiology, Van Training and Research Hospital, Van, Turkey 3 Department of Internal Medicine, Van Training and Research Hospital, Van, Turkey 4 Department of Anesthesiolgy, Van Training and Research Hospital, Van, Turkey 5 Department of Medical Oncology, Yuzuncu Yil University Medical Faculty, Van,Turkey 6 Department of Radiology, Yuzuncu Yil University Medical Faculty, Van,Turkey *Corresponding author: dr_erkandogan@hotmail.com Received June 17, 2015; Revised July 18, 2015; Accepted August 02, 2015 Abstract Background: Reversible Posterior Leukoencephalopathy Syndrome (RPLS) is a rare clinic-radiological condition. The clinical characteristics of this syndrome are headache, seizures, visual disturbances, confusion, and changes in mental status and focal neurological signs. The radiological characteristic of RPLS is bilateral symmetrical reversible vasogenic edema in the grey and white matter of the posterior part of the parietal-occipital lobes, consistent with hyperintensity in magnetic resonance imaging and computer tomography scans of the brain. Herein we report RPLS during the therapy with gemcitabine and cisplatin in a female patient with pancreatic cancer. Case Report: A 66-year-old female patient was admitted to the hospital because of abdominal pain. The results of computer tomography scans of the abdomen showed a 6-cm mass lesion in the tail of the pancreas and multiple metastatic lesions in the liver. A ‘tru-cut’ biopsy of the liver lesion proved to be consistent with adenocarcinoma. A combination chemotherapy regimen consisting of gemcitabine and cisplatin was planned. During this therapy, RPLS developed as a complication. Subsequent administration of chemotherapy was cancelled, and antihypertensive and anti-edema treatments were begun. Following this treatment the patient’s symptoms rapidly improved. There was a dramatic decline in vasogenic edema in control MRI scans which were performed a week later. Conclusion: Failure to diagnose the RPLS and correct the precipitating cause may result in catastrophic permanent brain injury or even death. Keywords: reversible posterior leukoencephalopathy syndrome, gemcitabine, cisplatin Cite This Article: Erkan Dogan, Cemile Ayse Gormeli, Mehmet Fatih Ozbay, Edip Gonullu, Alper Can, and Harun Arslan, “Gemcitabine and Cisplatin Induced Reversible Posterior Leukoencephalopathy Syndrome: A Case Report.” American Journal of Cancer Prevention, vol. 3, no. 4 (2015): 74-76. doi: 10.12691/ajcp-3-4-2. 1. Introduction Reversible Posterior Leukoencephalopathy Syndrome (RPLS) was first defined by Hinchey et al. in 1996 [1]. RPLS is a rare clinic-radiological condition, but with each passing day is more frequently diagnosed. The clinical characteristics of this syndrome are headache, seizures, visual disturbances, confusion, and changes in mental status and focal neurological signs [1]. The radiological characteristic of RPLS is bilateral symmetrical reversible vasogenic edema in the grey and white matter of the posterior part of the parietal-occipital lobes, consistent with hyperintensity in magnetic resonance imaging and computer tomography scans of the brain [1]. 2. Case Report A 66-year-old female patient was admitted to the hospital because of abdominal pain. The results of computer tomography scans of the abdomen showed a 6- cm mass lesion in the tail of the pancreas and multiple metastatic lesions in the liver. A ‘tru-cut’ biopsy of the liver lesion proved to be consistent with adenocarcinoma. A combination chemotherapy regimen consisting of gemcitabine and cisplatin was planned. The patient had no history of neurological disease or hypertension. Following the first cycle of chemotherapy, sudden loss of vision, headache, dizziness and problems with balance occurred. Therefore, magnetic resonance imaging (MRI) scans of the cranium were urgently taken. The MRI results revealed a vasogenic edema characterized by diffuse, symmetrical hyperintense areas in T2 and FLAIR images, in the bilateral centrum semiovale, periventricular areas and bilateral occipital lobes (Figure 1). The patient’s blood pressure was determined to be 170/95 mm Hg. RPLS has been diagnosed in patients with similar findings. Subsequent administration of chemotherapy was cancelled, and antihypertensive and anti-edema treatments were begun. Following this treatment the patient’s symptoms rapidly improved. There was a dramatic decline in