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.
Department of Medicine, Division of Gastroenterology and Hepatology, Shinshu University School of Medicine, Matsumoto, Japan. joshita@shinshu-u.ac.jp
Satoru
S
Joshita
Kaname
K
Yoshizawa
Kenji
K
Sano
Satoshi
S
Kobayashi
Tomohiro
T
Sekiguchi
Susumu
S
Morita
Atsushi
A
Kamijo
Michiharu
M
Komatsu
Takeji
T
Umemura
Tetsuya
T
Ichijo
Akihiro
A
Matsumoto
Eiji
E
Tanaka
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