Amenorrhea as a rare drug-related adverse event associated with everolimus for pancreatic neuroendocrine tumors

Abstract

The patient was an asymptomatic 43-year-old woman. Abdominal ultrasonography and enhanced computed tomography showed a tumor lesion accompanied by multiple cystic changes in the liver and the pancreatic tail. Endoscopic ultrasound-fine needle aspiration was performed on the pancreatic tumor lesion and revealed pancreatic neuroendocrine tumor (PNET). As it was unresectable due to multiple liver metastases, the decision was made to initiate treatment with everolimus and transcatheter arterial chemoembolization. The patient ceased menstruating after the start of everolimus administration. When the administration was discontinued due to interstitial lung disease, menstruation resumed, but then again stopped with everolimus resumption. An association between everolimus and amenorrhea was highly suspected. Amenorrhea occurred as a rare adverse event of everolimus. As the younger women might be included in PNETs patients, we should put this adverse event into consideration.

Keywords: Amenorrhea, Everolimus, Neuroendocrine tumor, Pancreas, Adverse event

Core tip: This is the first case report of amenorrhea as a rare adverse event associated with everolimus treatment for pancreatic neuroendocrine tumor. As the younger women might be included in pancreatic neuroendocrine tumors patients, we should put this adverse event into consideration.