BACKGROUND The angiogenesis inhibitor monoclonal antibody Bevacizumab is presently the standard treatment for numerous neoplasms but particular toxicities are emerging, such as hypertension, haemorrhage, thromboembolism, gastrointestinal perforation, fistulae, and delayed wound healing. The addition of Bevacizumab to radio and chemotherapy has improved the overall survival rate in patients with metastatic, persistent or recurrent cervical carcinoma. However an increased risk of enteric or urinary fistula formation has been documented, related to hypoxia which is induced by the inhibition of angiogenesis. Moreover, previous pelvic surgery, repeated ureteral stenting and radiation are additional risk factors. CASE PRESENTATION We describe the remarkable case of a right ureteral stent displacement inside the rectum lumen in a patient treated with Bevacizumab for pelvic recurrence of cervical cancer. The patient was referred to our Urology Department with urinary sepsis and bilateral hydronephrosis. Right ureteral stent substitution was planned; at cystoscopy the distal loop of the stent was not visualized inside the bladder. The presence of the distal loop of the right ureteral inside the rectum was clearly demonstrated with a CT scan. CONCLUSIONS Since Bevacizumab is increasingly used in the treatment of gynaecological neoplasms and indwelling ureteral stents are often required to treat or prevent ureteral compressions, similar cases are likely to be diagnosed and this complication should be considered in the management of advanced pelvic cancers.

中文翻译：

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放射化学疗法和贝伐单抗治疗后右输尿管支架直肠内移位的一例报道。

背景技术血管生成抑制剂单克隆抗体贝伐单抗目前是许多肿瘤的标准治疗方法，但是正在出现特定的毒性，例如高血压，出血，血栓栓塞，胃肠道穿孔，瘘管和伤口愈合延迟。在放疗和化疗中添加贝伐单抗可提高转移性​​，持续性或复发性宫颈癌患者的总生存率。然而，已经记录了与缺氧有关的肠或尿瘘形成风险增加，这是由于抑制血管生成而引起的。此外，以前的骨盆手术，反复输尿管支架置入术和放疗是另外的危险因素。病例介绍我们描述了贝伐单抗治疗宫颈癌的盆腔复发患者直肠内腔中右输尿管支架移位的明显病例。该患者因尿毒血症和双侧肾积水被转诊到我们的泌尿科。计划进行右输尿管支架置换术；在膀胱镜检查时，支架的远端环未在膀胱内看到。直肠内右输尿管远端环的存在已通过CT扫描清楚地证实。结论由于贝伐单抗越来越多地用于妇科肿瘤的治疗中，并且经常需要使用留置输尿管支架来治疗或预防输尿管压迫，因此很可能会诊断出类似的病例，并且这种并发症应在晚期盆腔癌的治疗中予以考虑。