Ptosis unilatéral induit par la vincristine : à propos d'un cas et revue de la littérature

We report the case of a 31-month-old girl, treated by the ifosfamide-vincristine-actinomycin chemotherapy protocol for vaginal rhabdomyosarcoma, who developed a unilateral left ptosis on day 36 of chemotherapy, i.e. 7 days after the fifth vincristine dose (1.5 mg/m2 or 0.90 mg). The cumulative vincristine dose was thus 4.50 mg. The remainder of the neurological and systemic examinations were unremarkable. Laboratory testing and thoracic-cervical-cranial CT were normal. Other causes of ptosis were excluded. The ptosis decreased a few days after the infusion of vincristine and re-increased just after a new dose. It finally resolved upon lowering the dose of vincristine. According to our observations, the role of vincristine in the pathogenesis of this ptosis appears “likely”. In such cases, maintenance of treatment is possible with adjustment of vincristine doses, but requires regular follow-up.