Nasal septum perforation induced by bevacizumab therapy for metastatic colorectal cancer

Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor receptors, has become a widely used treatment for various types of cancer, including metastatic colorectal cancer. However, while the benefits of bevacizumab in improving survival outcomes have been well-documented, it is important to consider the potential adverse effects associated with this therapy. We report a case of a male patient in his 50s with a history of metastatic colorectal cancer who began a regimen of bevacizumab in combination with chemotherapy. After several months of treatment, the patient began to experience rhinorrhoea and nasal crusting. Physical examination revealed a perforation of the nasal septum. While nasal septum perforation (NSP) is a known adverse effect of bevacizumab therapy, it is an uncommon occurrence, with only a few reported cases in the literature. Although no further extension of the NSP has been observed during the follow-up period, the treatment with bevacizumab was discontinued.