Abstract

We described a case that synovial sarcoma with lung metastasis, presenting with leukocytoclastic vasculitis after treatment with high dose ifosfamide. Forty-two years old male patient was admitted to the hospital due to anteromedial mass on his left arm. He was operated with the diagnosis of high grade synovial sarcoma and he received adjuvant treatment. 10 months later after the end of the therapy, numerous metastatic lung nodules developed and started high dose ifosfamide treatment. Stomachache, hematuria, erythematous lesions, palpable purpura on his bilateral lower extremities developed after 1weeks later of the starting chemotherapy. His autoantibodies were negative (anticardiolipin IG G/M, antiphospholipid Ig G/ M, antids DNA, ANA, pANCA, cANCA) and RF, C3, C4 were normal. Full-thickness skin biopsy resulted as leukocytoclastic vasculitis. After treatment 1 mg/kg prednisolone, patient's rash, hematuria, abdominal pain disappeared completely. We found that a possible relationship between ifosfamide and vasculitis according to Naranjo scale which envisioning the possibility of drug induced adverse drug effects. In the light of current knowledge, we found no cases developing leukocytoclastic vasculitis after ifosfamide treatment in the literature. Here, we wanted to emphasize that in patients treated with high dose ifosfamide might develop leukocytoclastic vasculitis, which is rare and unusual case.