title: [Vascular hepatic injury following neoadjuvant treatment for a cardial adenocarcinoma].
abstract: We report a case of a locally advanced cardial adenocarcinoma, occurring in a 48-year-old woman, who underwent concomitant radiotherapy and 5 FU-cis-platin based chemotherapy. Surgical tumor resection was then performed, which incidentally revealed an isolated liver nodule measuring 12 mm. This nodule was histologically characterized by an intense sinusoidal dilatation and a central venular occlusion, similar to that seen in veno-occlusive disease. This lesion was not correlated to any clinical or biological dysfunction and was finally considered as a vascular injury linked to the additive effect of the combined chemotherapy and radiotherapy. This observation illustrates some iatrogenic hepatic side effects, that have been rarely described in digestive cancers and mainly in the case of colo-rectal metastases. Vascular damage may remain histological, as in our case. But one should be aware that vascular injuries could influence hepatic function and regeneration after wide hepatectomy as well as extensive fibrosis.
authors.affiliation: Service d'Anatomie Pathologique, CRLC Val d'Aurelle, Montpellier. fbibeau@valdorel.fnclcc.fr
authors.forename: Frédéric
authors.initials: F
authors.lastname: Bibeau
authors.forename: David
authors.initials: D
authors.lastname: Azria
authors.forename: Marie-Christine
authors.initials: MC
authors.lastname: Chateau
authors.forename: Cécile
authors.initials: C
authors.lastname: Borrelly
authors.forename: Marc
authors.initials: M
authors.lastname: Ychou
authors.forename: François
authors.initials: F
authors.lastname: Quenet
authors.forename: Philippe
authors.initials: P
authors.lastname: Rouanet
mesh_terms: D000230:Adenocarcinoma / Q000628:therapy*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D002299:Cardia; D002945:Cisplatin / Q000008:administration & dosage; D005260:Female; D005472:Fluorouracil / Q000008:administration & dosage; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D011832:Radiation Injuries; D013274:Stomach Neoplasms / Q000628:therapy*
chemical_list: D002945:Cisplatin; D005472:Fluorouracil