Concurrent gastrointestinal perforation and pulmonary embolism due to bevacizumab in an adult undergoing treatment for stage IV colon cancer

Bevacizumab is an important component in the treatment of metastatic colorectal cancer when used with 5-fluorouracil, leucovorin and oxaliplatin or irinotecan. As a molecular target agent, it is considered to be less toxic than traditional chemotherapy; however, bevacizumab has been shown to cause serious, life-threatening adverse effects. The following report describes a case of bevacizumab-associated pulmonary embolism with simultaneous gastrointestinal perforation in a patient with stage IV adenocarcinoma of the descending colon. This case report and literature review describes the risk factors, etiology, and typical presentation of bevacizumab-induced gastrointestinal perforation and pulmonary embolism.