• Jana Halamkova, Tomas Kazda, Dagmar Adamkova-Krakorova, Sylva Rybnickova, Igor Kiss, and Regina Demlova.
• Department of Cancer Comprehensive Care, Masaryk Memorial Cancer Institute, Faculty of Medicine Masaryk University.
• Medicine (Baltimore). 2020 Oct 16; 99 (42): e22634.

RationaleUnilateral manifestation of lymphedema during everolimus therapy has been described only rarely, mostly in transplant recipients.Patient ConcernsWe report the first case of a patient who developed unilateral abdominal lymphedema, during a short period of everolimus treatment for renal cancer.DiagnosisThe abdominal asymmetry occurred only on the right side of the abdomen, neither ultrasound nor CT scan detected ascites but showed enlargement of the abdominal wall. The Naranjo Adverse Drug Reaction Probability scale was evaluated, in this case, a score of 6 indicated a probable adverse reaction to everolimus.InterventionsDiscontinuation of everolimus therapy led to immediate alleviation and reduction of the lymphedema, with worsening once again after initiating retreatment with everolimus at a reduced dose.OutcomesThe patient's lymphedema recovered after discontinuation of everolimus.LessonsThis rare case demonstrates the importance of the selection of mammalian target of rapamycin inhibitors using caution, especially for patients with a high risk of developing lymphedema.

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