A patient with advanced hepatocellular carcinoma treated with sorafenib tosylate showed massive tumor lysis with avoidance of tumor lysis syndrome.
A 33-year-old man presented with pain and palsy of the leg in 2008 for treatment of hepatocellular carcinoma with huge distant metastases. The patient's tumors had slowly enlarged despite several treatments. Oral administration of sorafenib at 800 mg/day with careful observation was commenced in 2009. Laboratory investigations on day 7 showed massive tumor lysis. An abdominal CT showed multiple low density areas and tumor markers decreased, indicating extended tumor necrosis. In conclusion, clinicians should bear in mind not only the published adverse effects, but also massive tumor lysis, when treating patients with large tumor burden by sorafenib.
Joshita
Satoru
S
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan. joshita@shinshu-u.ac.jp
Yoshizawa
Kaname
K
Sano
Kenji
K
Kobayashi
Satoshi
S
Sekiguchi
Tomohiro
T
Morita
Susumu
S
Kamijo
Atsushi
A
Komatsu
Michiharu
M
Umemura
Takeji
T
Ichijo
Tetsuya
T
Matsumoto
Akihiro
A
Tanaka
Eiji
E
D000328:Adult; D001557:Benzenesulfonates / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy* / Q000473:pathology; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000473:pathology; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000009:adverse effects*; D000077157:Sorafenib; D015275:Tumor Lysis Syndrome / Q000175:diagnosis* / Q000209:etiology*
D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib