Fatty liver change as a result of hepatic artery infusion chemotherapy.
Direct hepatic arterial infusion of floxuridine (FUDR) (Roche Laboratories, Division of Hoffman-LaRoche Inc., Nutley, NJ, U.S.A.) has been used extensively in the treatment of metastases of colorectal tumors to the liver. The effectiveness of infusion and tolerance of the chemotherapy has been improved utilizing a totally implantable infusion pump delivery system. However, unequal distribution of drug infusion may occur to different parts of the liver parenchyma as demonstrated by hepatic arterial infusion scintigraphy (HAPS). We present a case of such unequal perfusion in which fatty metamorphosis of the liver occurred in the overperfused liver segment after FUDR therapy. The liver parenchymal changes were followed by serial computerized tomography scans and proven by biopsy during a minilaparotomy. Serial HAPS examinations show redirection of subsequent infusion to the opposite liver lobe due to parenchymal damage and vascular sclerosis. The importance of uniform liver perfusion and a rare dose-related effect of FUDR on liver parenchyma are thereby demonstrated.
Zeiss
J
J
Department of Radiology, Medical College of Ohio, Toledo 43699.
Merrick
H W
HW
Savolaine
E R
ER
Woldenberg
L S
LS
Kim
K
K
Schlembach
P J
PJ
D003110:Colonic Neoplasms / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D005234:Fatty Liver / Q000139:chemically induced* / Q000000981:diagnostic imaging; D005467:Floxuridine / Q000008:administration & dosage / Q000009:adverse effects* / Q000493:pharmacokinetics; D006499:Hepatic Artery; D006801:Humans; D007261:Infusions, Intra-Arterial; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D013668:Technetium Tc 99m Aggregated Albumin; D014018:Tissue Distribution; D014057:Tomography, X-Ray Computed
D013668:Technetium Tc 99m Aggregated Albumin; D005467:Floxuridine