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A case of liver fibrosis with splenomegaly after oxaliplatin-based adjuvant chemotherapy for colon cancer.

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 α-smooth muscle actin (α-SMA) were conducted with control group. The immunohistochemical stains for CD31 and α-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.
AuthorsGu Hyum Kang, Hee Seok Moon, Eaum Seok Lee, Seok Hyun Kim, Jae Kyu Sung, Byung Seok Lee, Hyun Yong Jeong, Heon Young Lee, Dae Young Kang
JournalJournal of Korean medical science (J Korean Med Sci) Vol. 28 Issue 12 Pg. 1835-8 (Dec 2013) ISSN: 1598-6357 [Electronic] Korea (South)
PMID24339718 (Publication Type: Case Reports, Journal Article)
Chemical References
  • ACTA2 protein, human
  • Actins
  • Organoplatinum Compounds
  • Platelet Endothelial Cell Adhesion Molecule-1
  • Oxaliplatin
  • Leucovorin
  • Fluorouracil
  • Camptothecin
Topics
  • Actins (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)
  • Oxaliplatin
  • Platelet Endothelial Cell Adhesion Molecule-1 (metabolism)
  • Splenomegaly (diagnosis, etiology)
  • Thrombocytopenia (etiology)
  • Tomography, X-Ray Computed

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