Obstructive Jaundice Due to Duodenal Ulcer Induced by Lenvatinib Therapy for Hepatocellular Carcinoma.

Abstract

An 82-year-old man with hepatocellular carcinoma presented with upper abdominal pain, vomiting, and jaundice. He had been taking a standard lenvatinib dose for three months. Although acute cholangitis was suggested, imaging studies failed to detect the biliary obstruction site. An endoscopic examination following discontinuation of lenvatinib and aspirin revealed multiple duodenal ulcers, one of which was formed on the ampulla of Vater and causing cholestasis. Endoscopic biliary drainage and antibiotics improved concomitant Enterobacter cloacae bacteremia. Ulcer healing was confirmed after rabeprazole was replaced with vonoprazan and misoprostol. Our case shows that lenvatinib can induce duodenal ulcers resulting in obstructive jaundice.

• Authors: Maito Suoh, Atsushi Hagihara, Masafumi Yamamura, Hirotsugu Maruyama, Koichi Taira, Masaru Enomoto, Akihiro Tamori, Yasuhiro Fujiwara, Norifumi Kawada
• Journal: Internal medicine (Tokyo, Japan) (Intern Med) Vol. 60 Issue 4 Pg. 545-552 (Feb 15 2021) ISSN: 1349-7235 [Electronic] Japan
• PMID: 33028766 (Publication Type: Case Reports, Journal Article)

Chemical References

• Phenylurea Compounds
• Quinolines
• lenvatinib

Topics

• Aged, 80 and over
• Carcinoma, Hepatocellular (drug therapy)
• Duodenal Ulcer (chemically induced, diagnosis)
• Humans
• Jaundice, Obstructive (chemically induced)
• Liver Neoplasms (drug therapy)
• Male
• Phenylurea Compounds
• Quinolines