A Case of Liver Fibrosis with Splenomegaly after Oxaliplatin-Based Adjuvant Chemotherapy for Colon Cancer.
10.3346/jkms.2013.28.12.1835
- Author:
Gu Hyum KANG
1
;
Hee Seok MOON
;
Eaum Seok LEE
;
Seok Hyun KIM
;
Jae Kyu SUNG
;
Byung Seok LEE
;
Hyun Yong JEONG
;
Heon Young LEE
;
Dae Young KANG
Author Information
1. Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea. mhs1357@cnuh.co.kr
- Publication Type:Case Reports
- Keywords:
Liver Cirrhosis;
Splenomegaly;
Oxaliplatin
- MeSH:
Actins/metabolism;
Antigens, CD31/metabolism;
Antineoplastic Combined Chemotherapy Protocols/*therapeutic use;
Camptothecin/*analogs & derivatives/therapeutic use;
Chemotherapy, Adjuvant;
Colonic Neoplasms/*drug therapy;
Fluorouracil/therapeutic use;
Humans;
Hypertension, Portal/etiology;
Immunohistochemistry;
Leucovorin/therapeutic use;
Liver Cirrhosis/*diagnosis/etiology/pathology;
Liver Neoplasms/secondary/surgery;
Male;
Middle Aged;
Organoplatinum Compounds/*administration & dosage/adverse effects/therapeutic use;
Splenomegaly/*diagnosis/etiology;
Thrombocytopenia/etiology;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2013;28(12):1835-1838
- CountryRepublic of Korea
- Language:English
-
Abstract:
Previous studies reported that oxaliplatin is associated with sinusoidal obstruction syndrome. However few reports on oxaliplatin induced liver fibrosis are found in the literature. Furthermore pathogenesis of liver fibrosis is not well known. We report a case of 45-yr-old Korean man in whom liver fibrosis with splenomegaly developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for colon cancer (T4N2M0). Thorough history taking and serological examination revealed no evidence of chronic liver disease. Restaging CT scans demonstrated a good response to chemotherapy. Five month after chemotherapy, he underwent right hepatectomy due to isolated metastatic lesion. The liver parenchyma showed diffuse sinusoidal dilatation and centrilobular vein fibrosis with necrosis without steatosis. We could conclude that splenomegaly was due to perisinusoidal liver fibrosis and liver cell necrosis induced portal hypertension by oxaliplatin. In addition, to investigate the pathogenesis of liver fibrosis, immunohistochemical stains such as CD31 and alpha-smooth muscle actin (alpha-SMA) were conducted with control group. The immunohistochemical stains for CD31 and alpha-SMA were positive along the sinusoidal space in the patient, while negative in the control group. Chemotherapy with oxaliplatin induces liver fibrosis which should be kept in mind as a serious complication.
