Successful treatment of ruptured hepatocellular carcinoma with intraperitoneal injection of OK-432.
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.
Shiratori
Masatoshi
M
Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
Nagashima
Ikuo
I
Takada
Tadahiro
T
Morofuji
Shinichiro
S
Motomiya
Hiroshi
H
Matsuda
Keiji
K
Inaba
Tsuyoshi
T
Fukushima
Junichi
J
Okinaga
Kota
K
D000970:Antineoplastic Agents / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007274:Injections, Intraperitoneal; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010844:Picibanil / Q000627:therapeutic use*; D012422:Rupture, Spontaneous
D000970:Antineoplastic Agents; D010844:Picibanil