Acute Type A Aortic Dissection During Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitor Lenvatinib Therapy

A 67-year-old male with hepatocellular carcinoma under lenvatinib therapy suffered from initially back pain and then abdominal pain, dyspnea, and oliguria. Acute type A aortic dissection was diagnosed with point-of-care ultrasound and computed tomography during the admission. Patients treated with vascular endothelial growth factor tyrosine kinase inhibitors (VEGF-TKIs) have a low but significant risk of aortic dissection. As a newer member of VEGF-TKIs, lenvatinib has a similar or even higher risk of aortic dissection compared to others. Clinicians should take the cardiovascular risk into consideration while prescribing lenvatinib and keep the differential diagnosis of aortic dissection in mind during the therapy.