Sclerosing cholangitis in the era of target chemotherapy: a possible anti-VEGF effect.
Preoperative systemic chemotherapy is generally applied in patients who undergo hepatic resection for colorectal metastases. Although the tumour response rate has been improved recently with the development of new molecular targeted therapies the related hepatic injury is ill defined. Bevacizumab is a monoclonal antibody to vascular endothelial growth factor. It can achieve high response rates and is accepted as a first line treatment in the metastatic colorectal disease. However, the data about its hepatotoxicity profile is still limited. We describe a case of secondary sclerosing cholangitis in a patient with liver metastases treated by Bevacizumab in the neoadjuvant setting and liver resection. It is possible that Bevacizumab may have induced a hypercoagulative condition that was further precipitated by surgery.
Delis
S
S
Liver Surgical Unit, 1st Surgery Department, Agia Olga Hospital, Athens, Greece.
Triantopoulou
C
C
Bakoyiannis
A
A
Tassopoulos
N
N
Athanasiou
K
K
Dervenis
C
C
D000230:Adenocarcinoma / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D001219:Aspartate Aminotransferases / Q000097:blood; D000068258:Bevacizumab; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D015209:Cholangitis, Sclerosing / Q000139:chemically induced* / Q000175:diagnosis; D006498:Hepatectomy / Q000009:adverse effects; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000188:drug therapy / Q000556:secondary* / Q000601:surgery; D008297:Male; D020360:Neoadjuvant Therapy / Q000009:adverse effects; D012811:Sigmoid Neoplasms / Q000188:drug therapy / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase