A case report of bevacizumab-induced subcapsular renal hemorrhage in a patient with lung adenocarcinoma.

This article reports a case of bilateral renal subcapsular hemorrhage in a 51-year-old female patient with lung adenocarcinoma and multiple metastases after receiving four cycles of combination antitumor therapy with pemetrexed, carboplatin, sintilimab, and bevacizumab. The patient had a pre-existing cystic lesion in the right kidney and developed intermittent fever, hypertension, and anemia during treatment. The diagnosis was confirmed by a renal contrast-enhanced CT scan. Management involved immediate discontinuation of bevacizumab, absolute bed rest, hemostasis, antihypertensive therapy, and other comprehensive treatments. The renal hemorrhage was effectively controlled and gradually resolved. Based on the temporal relationship of medication use and clinical manifestations, the renal hemorrhage was considered to be associated with bevacizumab. In recent years, bevacizumab has been widely used in tumor treatment; however, its adverse effects still require further exploration. Hemorrhage induced by bevacizumab primarily occurs in the respiratory tract, digestive tract, and brain, while renal subcapsular hemorrhage has not been reported. This case suggests that bleeding manifestations caused by bevacizumab are diverse and remain a cause for vigilance.