A case of severe acalculous cholecystitis associated with sorafenib treatment for advanced hepatocellular carcinoma

Sorafenib,a multikinase inhibitor,is the first and only drug,which improves significantly the overall survival in patients with advanced hepatocellular carcinoma(HCC).However,many patients experience diverse side effects,some of them severe and unexpected.To date,acute acalculous cholecystitis has n...

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Published inWorld journal of gastrointestinal oncology Vol. 4; no. 5; pp. 115 - 118
Main Authors Aihara, Yosuke, Yoshiji, Hitoshi, Yamazaki, Masaharu, Ikenaka, Yasuhide, Noguchi, Ryuichi, Morioka, Chie, Kaji, Kosuke, Tastumi, Haruki, Nakanishi, Keisuke, Nakamura, Maiko, Yamao, Junichi, Toyohara, Masahisa, Mitoro, Akira, Sawai, Masayoshi, Yoshida, Motoyuki, Fujimoto, Masao, Uemura, Masahito, Fukui, Hiroshi
Format Journal Article
LanguageEnglish
Published China Baishideng Publishing Group Co., Limited 15.05.2012
Subjects
Acalculous
carcinoma
Case Report
cholecystitis
Hepatocelluar
Sorafenib
Sorafenib
Acalculous cholecystitis
Hepatocelluar carcinoma
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Summary:Sorafenib,a multikinase inhibitor,is the first and only drug,which improves significantly the overall survival in patients with advanced hepatocellular carcinoma(HCC).However,many patients experience diverse side effects,some of them severe and unexpected.To date,acute acalculous cholecystitis has not been documented in association with a HCC patient treated with sorafenib.Here,we report the case of a 43-yearold woman with hepatitis C virus-related advanced HCC.She received sorafenib,and later complained ofa sudden onset of severe right hypocondrial pain with rebound tenderness and muscle defense.Laboratory examination showed mild elevation of transaminases,biliary enzymes,bilirubin,inflammation markers,and a marked peripheral eosinophilia.Abdominal computed tomography(CT) revealed a swollen gallbladder with exudate associated with severe inflammation without stones or debris.Consequently,sorafenib treatment was stopped immediately,and steroid-pulse therapy was performed.Steroid therapy drastically improved all clinical manifestations along with normalization of CT findings,eosinophilia,and liver functions.In summary,we herein report a rare case of acute severe acalculous cholecystitis associated with sorafenib in the patient with advanced HCC.
Bibliography:Yosuke Aihara,Hitoshi Yoshiji,Masaharu Yamazaki,Yasuhide Ikenaka,Ryuichi Noguchi,Chie Morioka,Kosuke Kaji,Haruki Tastumi,Keisuke Nakanishi,Maiko Nakamura,Junichi Yamao,Masahisa Toyohara,Akira Mitoro,Masayoshi Sawai,Motoyuki Yoshida,Masao Fujimoto,Masahito Uemura,Hiroshi Fukui,Third Department of Internal Medicine,Nara Medical University,Nara 634-8522,Japan
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Author contributions: Aihara Y and Yoshiji H described the clinical case, obtained informed consent from the patient, conceived the study, participated in its design, assisted in data collection, coordinated and helped draft the manuscript; Yoshiji H undertook the literature research and contributed to the writing; Yamazaki M, Ikenaka Y, Noguchi R, Morioka C, Kaji K, Tatsumi H, Nakanishi K, Nakamura M, Yamao J, Toyohara M, Mitoro A, Sawai M, Yoshida M, Fujimoto M, Uemura M and Fukui H were responsible for the diagnosis, patient management and review.
Telephone: +81-744-223051-2314 Fax: +81-744-247122
Correspondence to: Hitoshi Yoshiji, MD, PhD, Third Department of Internal Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8522, Japan. yoshijih@naramed-u.ac.jp
ISSN:1948-5204
1948-5204
DOI:10.4251/wjgo.v4.i5.115