Leukoencephalopathy Following Treatment with Carmofur: A Case Report and Review of the Japanese Literature

A 53-year-old woman was treated with 5 courses of CAP treatment following operation for FIGO Stage Ia cancer of the ovary in September 1986. And in April 1987, she started an oral adjuvant chemotherapy with 400 mg/day of carmofur. In early June, she developed vertigo and dysarthia and was hospitalized. A CT scan showed low-density areas adjacent to both lateral ventricles, and an EEG revealed abnormally slow waves. She improved gradually after carmofur was discontinued and left the hospital in October 1987. There have been 24 reported cases of leukoencephalopathy because of carmofur in Japan, but the pathophysiological mechanism involved is not known. Since it is more common in women than in men, its incidence will probably increase in gynecological patients. Therefore, we must be on the lookout for central nervous system signs and symptoms in patients receiving adjuvant chemotherapy with carmofur.