title: Sorafenib, risk of bleeding and spontaneous rupture of hepatocellular carcinoma. A clinical case.
abstract: Spontaneous rupture is a rare and dramatic complication ofhepatocellular carcinoma (HCC), burdened by a high mortality. Here we describe a case of a 73-year-old man, who arrived at the ER because of syncope, and acute epigastric and right upper quadrant abdominal pain. He had a history of hepatitis C-related liver cirrhosis and HCC in treatment with sorafenib. The physical examination showed a state of hemorrhagic anemia with the presence of blood in the peritoneal cavity. The patient underwent an urgent liver resection. Thirty days after surgery, he was in good general condition. Sorafenib is a multikinase inhibitor recently introduced in the therapy of patients with advanced HCC. Among the various side effects reported in patients treated with sorafenib, there is a higher risk of bleeding. In conclusion, sorafenib may increase the risk of bleeding and rupture of HCC in susceptible individuals.
authors.affiliation: Emergency Medicine Unit, "Jazzolino" Hospital, Vibo Valentia, Italy. f.rombola@alice.it
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Rombolà
authors.forename: Angelo
authors.initials: A
authors.lastname: Caravetta
authors.forename: Francesco
authors.initials: F
authors.lastname: Mollo
authors.forename: Antonio
authors.initials: A
authors.lastname: Spinoso
authors.forename: Lenino
authors.initials: L
authors.lastname: Peluso
authors.forename: Raffaele
authors.initials: R
authors.lastname: Guarino
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D001557:Benzenesulfonates / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000188:drug therapy*; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications / Q000188:drug therapy*; D008297:Male; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000009:adverse effects*; D012422:Rupture, Spontaneous / Q000150:complications; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib