Spontaneous perirenal hematoma induced by regorafenib

A 53-year-old female patient with multiple metastases of colon cancer was treated with regorafenib 120 mg/d orally (21 days of medication and 7 days of withdrawal was defined as 1 cycle). On the 7th day of regorafenib treatment, the patient developed intermittent pain in the right upper abdomen and waist, which was gradually aggravated. After 20 days of waist pain, renal ultrasound and abdominal CT examination showed a right perirenal subcapsular hematoma and laboratory tests showed hemoglobin 99 g/L and normal coagulation function. Spontaneous perinephric hematoma due to regorafenib was considered. Regorafenib was discontinued, the patient was instructed to stay in bed, and hemostasis and rehydration therapy was given. After 11 days of drug withdrawal, the patient′s lumbar pain was improved and hemoglobin returned to 102 g/L. After 2 months of drug withdrawal, abdominal ultrasound showed that the right perirenal hematoma was reduced and hemoglobin returned to normal.