Autopsy and Cardiac Magnetic Resonance Image Case of Bevacizumab-Related Cardiomyopathy

We report an autopsy case of a 69-year-old female with cervical cancer. She was given bevacizumab-containing chemotherapy for 4 months. After two years of chemotherapy, she developed congestive heart failure (CHF) with left ventricular dysfunction. Cardiac magnetic resonance (CMR) imaging revealed late gadolinium enhancement (LGE) of linear mid-wall delayed enhancement located in the basal to the mid-septal wall, suggesting bevacizumab-related cardiotoxicity. Although she was treated with cardioprotective medications and discharged, she eventually died from worsening CHF a year later, and we conducted an autopsy. Histopathological examination revealed diffuse fibrosis in the myocardium, and the area where LGE was present on CMR showed thinning and wavy changes in cardiomyocytes with diffuse interstitial fibrosis and edema.

Automated summary

We present an autopsy case of a 69-year-old female with cervical cancer who received bevacizumab-containing chemotherapy. After two years, she developed congestive heart failure (CHF) with left ventricular dysfunction. Cardiac magnetic resonance (CMR) imaging revealed late gadolinium enhancement (LGE) in the mid-wall area, suggesting bevacizumab-related cardiotoxicity. Autopsy findings showed diffuse fibrosis in the myocardium, and the area of LGE seen on CMR exhibited thinning and wavy changes in cardiomyocytes with diffuse interstitial fibrosis and edema.