Successful treatment of ruptured hepatocellular carcinoma with intraperitoneal injection of OK‐432

• Published in: Journal of Hepato‐Biliary‐Pancreatic Surgery Vol. 11; no. 6; pp. 426 - 429
• Main Authors: Shiratori, Masatoshi, Nagashima, Ikuo, Takada, Tadahiro, Morofuji, Shinichiro, Motomiya, Hiroshi, Matsuda, Keiji, Inaba, Tsuyoshi, Fukushima, Junichi, Okinaga, Kota
• Format: Journal Article
• Language: English
• Published: Japan 01.12.2004
• Subjects: Antineoplastic Agents - therapeutic use; Carcinoma, Hepatocellular - drug therapy; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Humans; Injections, Intraperitoneal; Liver Neoplasms - drug therapy; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Male; Middle Aged; OK‐432; Picibanil - therapeutic use; Rupture, Spontaneous; ruptured hepatocellular carcinoma
• ISSN: 0944-1166; 1868-6982; 1436-0691
• DOI: 10.1007/s00534-004-0921-8

We report a 51‐year‐old man with a ruptured hepatocellular carcinoma (HCC). He was admitted to the hospital with abdominal pain and distension. Imaging studies revealed massive ascites, liver cirrhosis, and a 3‐cm tumor at the inferior edge of the medial segment of the liver, with adhesions to the greater omentum. Abdominal paracentesis showed bloody ascites, and the patient was diagnosed with a ruptured HCC. OK‐432, an immunomodulatory agent prepared from an attenuated strain of Streptococcus pyogenes, was injected (10 KE) into the peritoneal cavity four times within 1 week; the massive ascites disappeared, and the serum alpha‐fetoprotein (AFP) level decreased to within the normal limits. Afterwards, he underwent a curative operation for HCC. His postoperative course was uneventful and he was discharged from the hospital on the twenty‐second postoperative day. He had shown no evidence of recurrence or metastases at the time he died of hepatic failure related to alcohol abuse 9 months after the operation.