Spontaneous splenic rupture as a rare complication of G-CSF injection

BMJ Case Rep. 2018 Jan 12:2018:bcr2017222561. doi: 10.1136/bcr-2017-222561.


Splenic rupture is an infrequent and underdiagnosed side effect of granylocyte colony-stimulating factor (G-CSF). We report the case of a 54-year-old woman with brain and bone metastasis in a lung adenocarcinoma who was admitted for faintness 28 days after a G-CSF injection. Abdominal CT scan confirmed the diagnosis of splenic rupture. A conservative treatment was chosen using a peritoneal cleansing during laparoscopic surgery. Clinicians should be aware of this rare toxicity as it could be severe, but easily reversible using appropriate surgical treatment. Even if prognosis remains poor for patients with lung cancer, invasive procedures could be considered in this rapidly evolving setting, especially in case of reversible adverse event.

Keywords: lung cancer (oncology); unwanted effects / adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / drug therapy*
  • Adenocarcinoma / pathology
  • Adenocarcinoma of Lung
  • Antineoplastic Combined Chemotherapy Protocols
  • Bone Neoplasms / drug therapy*
  • Bone Neoplasms / secondary
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / secondary
  • Female
  • Granulocyte Colony-Stimulating Factor / administration & dosage*
  • Granulocyte Colony-Stimulating Factor / adverse effects
  • Humans
  • Injections / adverse effects*
  • Laparoscopy
  • Lung Neoplasms / drug therapy*
  • Lung Neoplasms / pathology
  • Middle Aged
  • Peritoneal Dialysis / methods*
  • Rupture, Spontaneous / etiology
  • Rupture, Spontaneous / physiopathology
  • Rupture, Spontaneous / therapy*
  • Splenic Rupture / diagnostic imaging
  • Splenic Rupture / etiology*
  • Syncope
  • Treatment Outcome


  • Granulocyte Colony-Stimulating Factor