Hepatopathy following irradiation and chemotherapy for Wilms' tumor.
Two children being treated with combination chemotherapy and irradiation for localized, rightsided Wilms' tumor developed sudden enlargement of the liver with defects on liver scintigram resembling liver metastases. One child also developed pancytopenia. When chemotherapy was temporarily withheld in both children, hepatomegaly and scintigram abnormalities resolved. The planned courses of chemotherapy were subsequently completed without complications. The clinical course in our patients is compared to previously published experiences. Awareness of this complication could prevent the mistaken diagnosis of metastatic disease and emphasizes the care necessary when administering cytotoxic drugs to children receiving irradiation to all or a portion of the liver.
D000970:Antineoplastic Agents / Q000009:adverse effects*; D002675:Child, Preschool; D003609:Dactinomycin / Q000009:adverse effects; D003951:Diagnostic Errors; D004317:Doxorubicin / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006529:Hepatomegaly / Q000139:chemically induced*; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D008297:Male; D011877:Radionuclide Imaging; D011879:Radiotherapy Dosage; D013455:Sulfur; D013667:Technetium; D013671:Technetium Tc 99m Sulfur Colloid; D014750:Vincristine / Q000009:adverse effects; D009396:Wilms Tumor / Q000628:therapy*
D000970:Antineoplastic Agents; D003609:Dactinomycin; D013671:Technetium Tc 99m Sulfur Colloid; D014750:Vincristine; D013455:Sulfur; D013667:Technetium; D004317:Doxorubicin