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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 330:1811-1817 June 23, 1994 Number 25
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Case 25-1994— A 58-Year-Old Woman with Bloody Diarrhea after Chemotherapy for Carcinoma of the Tongue
Sherwood L. Gorbach, Fiona Graeme-Cook, and R. Neal Smith

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Presentation of Case

A 58-year-old woman was admitted to the hospital because of intractable diarrhea after chemotherapy for carcinoma of the tongue.

Five months before admission, the patient had received radiation therapy for a stage T4N2cM0 squamous-cell carcinoma of the tongue, followed by the administration of two cycles of fluorouracil, cisplatin, bleomycin, and methotrexate; the second cycle was begun 22 days before admission. The patient experienced only minor soreness of the mouth after the first cycle of chemotherapy and negligible side effects during the two weeks after the second cycle.

Four days before admission, diarrhea developed, with crampy abdominal pain, nausea, dry heaves, . . . [Full Text of this Article]

Differential Diagnosis

Clinical Diagnosis

Dr. Sherwood L. Gorbach's Diagnosis

Pathological Discussion

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