Background: Reversible posterior leukoencephalopathy syndrome (RPLS) is a clinical and radiologic syndrome of heterogeneous etiology. Although it has been described in association with intravenous cytotoxic chemotherapy including cisplatin and molecularly targeted therapies such as bevacizumab and sorafenib, it has not been described in the setting of intraperitoneal chemotherapy.
Case: A 64-year-old woman with stage IIIC fallopian tube cancer developed acute mental status changes and radiologic findings consistent with RPLS in conjunction with hypertension after one cycle of intravenous paclitaxel, followed by intraperitoneal (IP) cisplatin. Symptoms resolved over the course of 4 days with no obvious residual effects.
Conclusion: The use of an intravenous paclitaxel and intraperitoneal cisplatin regimen can be associated with RPLS. Hypertension should be controlled in patients prior to receiving this chemotherapy regimen due to potential toxicity.