title: Successful treatment of ruptured hepatocellular carcinoma with intraperitoneal injection of OK-432.
abstract: 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.
authors.affiliation: Department of Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Shiratori
authors.forename: Ikuo
authors.initials: I
authors.lastname: Nagashima
authors.forename: Tadahiro
authors.initials: T
authors.lastname: Takada
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Morofuji
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Motomiya
authors.forename: Keiji
authors.initials: K
authors.lastname: Matsuda
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Inaba
authors.forename: Junichi
authors.initials: J
authors.lastname: Fukushima
authors.forename: Kota
authors.initials: K
authors.lastname: Okinaga
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D010844:Picibanil