title: Oxaliplatin-induced liver injury mimicking metastatic tumor on images: a case report.
abstract: Oxaliplatin-based chemotherapy is widely used for advanced colorectal cancer treatment, but it occasionally induces liver injury that is characterized histologically by sinusoidal dilatation, hepatic plate atrophy and/or venular obstruction. Most of the patients do not reveal apparent radiological abnormalities, however. Here, we report the case of a 47-year-old man with a radiologically detectable mass-forming oxaliplatin-induced sinusoidal injury that mimicked multiple liver tumors. These mass lesions were found on computed tomography images after the administration of six cycles of folinic acid, fluorouracil and oxaliplatin therapy as adjuvant chemotherapy for Stage III rectal cancer. The patient had to undergo liver resection because imaging studies could not exclude metastases. The histological examination revealed that a resected mass lesion was composed of severe sinusoidal dilatation. Milder dilatation was also seen in the surrounding parenchyma. We diagnosed the patient as having an oxaliplatin-induced sinusoidal injury with severe deviation. As oxaliplatin is a standard agent in colorectal cancer therapy today, all clinicians and pathologists should be aware of such non-neoplastic lesions as one of the rare differential diagnoses of metastatic liver tumor, to prevent overtreatment.
authors: *Department of Pathology, Japanese Red Cross Society Himeji Hospital, 1-12-1 Shimoteno, Himeji 670-8540, Japan. kaoriuchino@yahoo.co.jp.
authors: Kaori
authors: K
authors: Uchino
authors: Masayoshi
authors: M
authors: Fujisawa
authors: Takanori
authors: T
authors: Watanabe
authors: Yoshikatsu
authors: Y
authors: Endo
authors: Tetsuji
authors: T
authors: Nobuhisa
authors: Yusuke
authors: Y
authors: Matsumoto
authors: Kyohei
authors: K
authors: Kai
authors: Shiso
authors: S
authors: Sato
authors: Kenji
authors: K
authors: Notohara
authors: Akihiro
authors: A
authors: Matsukawa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects*; D017024:Chemotherapy, Adjuvant; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D003937:Diagnosis, Differential; D005472:Fluorouracil / Q000009:adverse effects; D006498:Hepatectomy; D006801:Humans; D002955:Leucovorin / Q000009:adverse effects; D008099:Liver / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000601:surgery; D008113:Liver Neoplasms / Q000556:secondary*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009944:Organoplatinum Compounds / Q000009:adverse effects*; D000077150:Oxaliplatin; D014057:Tomography, X-Ray Computed
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil
keywords: colorectal liver metastases; oxaliplatin; sinusoidal obstruction syndrome