title: Multiple hepatocellular carcinomas developed 15 months after commencement of chemotherapy for elderly acute myelogenous leukemia.
abstract: In May 2006, a 72-year-old man with acute myelogenous leukemia (M4Eo) was admitted to our hospital. He had been receiving antiandrogen treatment for prostate cancer (after an operation in 1998) and treatment for diabetes mellitus. He received chemotherapy according to the JALSG GML200 protocol, which led to complete remission; however, in January 2007, his leukemia recurred. CAG combination chemotherapy also resulted in complete remission by May 2007. In August 2007, he developed multiple liver tumors, abdominal pain, and fever. Contrast-enhanced computed tomography revealed hypovascular tumors in both early and delayed phases. Angiography showed ring-like tumor staining and a massive tumor, similar to those seen in metastatic hepatocellular carcinomas (HCCs). He eventually died because of aggressive enlargement of liver tumors during the following month accompanied by the simultaneous recurrence of leukemia and unsuccessful embolization of the hepatic artery. Autopsy specimens showed fibrosis and considerable iron deposition in the liver, suggested secondary hemochromatosis due to transfusion. We also detected multiple moderately differentiated primary HCCs. Secondary hemochromatosis, androgen imbalance, and humoral factors from leukemic cells were believed to be the causes of the rapid onset and development of HCCs.
authors.affiliation: Division of Internal Medicine, Health Insurance Naruto Hospital.
authors.forename: Shingen
authors.initials: S
authors.lastname: NAKAMURA
authors.forename: Toshiaki
authors.initials: T
authors.lastname: TAKEICHI
authors.forename: Chihiro
authors.initials: C
authors.lastname: YAMANAKA
authors.forename: Kana
authors.initials: K
authors.lastname: SHICHIJO
authors.forename: Koji
authors.initials: K
authors.lastname: TAKAHASHI
authors.forename: Yukiko
authors.initials: Y
authors.lastname: HIASA
authors.forename: Takaya
authors.initials: T
authors.lastname: MATSUSHITA
authors.forename: Noriaki
authors.initials: N
authors.lastname: HORIUCHI
authors.forename: Yasutami
authors.initials: Y
authors.lastname: TAMAKI
authors.forename: Shigeaki
authors.initials: S
authors.lastname: KIMURA
authors.forename: Hiroshi
authors.initials: H
authors.lastname: FUJIMOTO
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: MASUDA
authors.forename: Sadao
authors.initials: S
authors.lastname: SHINOMIYA
mesh_terms: D015250:Aclarubicin / Q000008:administration & dosage; D000368:Aged; D000726:Androgen Antagonists / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use*; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D003561:Cytarabine / Q000008:administration & dosage; D017809:Fatal Outcome; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage; D006432:Hemochromatosis / Q000209:etiology; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000188:drug therapy*; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male; D016609:Neoplasms, Second Primary; D011471:Prostatic Neoplasms / Q000628:therapy; D013997:Time Factors
chemical_list: D000726:Androgen Antagonists; D003561:Cytarabine; D016179:Granulocyte Colony-Stimulating Factor; D015250:Aclarubicin