title: A case of liver fibrosis with splenomegaly after oxaliplatin-based adjuvant chemotherapy for colon cancer.
abstract: Previous studies reported that oxaliplatin is associated with sinusoidal obstruction syndrome. However few reports on oxaliplatin induced liver fibrosis are found in the literature. Furthermore pathogenesis of liver fibrosis is not well known. We report a case of 45-yr-old Korean man in whom liver fibrosis with splenomegaly developed after 12 cycles of oxaliplatin based adjuvant chemotherapy for colon cancer (T4N2M0). Thorough history taking and serological examination revealed no evidence of chronic liver disease. Restaging CT scans demonstrated a good response to chemotherapy. Five month after chemotherapy, he underwent right hepatectomy due to isolated metastatic lesion. The liver parenchyma showed diffuse sinusoidal dilatation and centrilobular vein fibrosis with necrosis without steatosis. We could conclude that splenomegaly was due to perisinusoidal liver fibrosis and liver cell necrosis induced portal hypertension by oxaliplatin. In addition, to investigate the pathogenesis of liver fibrosis, immunohistochemical stains such as CD31 and α-smooth muscle actin (α-SMA) were conducted with control group. The immunohistochemical stains for CD31 and α-SMA were positive along the sinusoidal space in the patient, while negative in the control group. Chemotherapy with oxaliplatin induces liver fibrosis which should be kept in mind as a serious complication.
authors: Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea.
authors: Gu Hyum
authors: GH
authors: Kang
authors: Hee Seok
authors: HS
authors: Moon
authors: Eaum Seok
authors: ES
authors: Lee
authors: Seok Hyun
authors: SH
authors: Kim
authors: Jae Kyu
authors: JK
authors: Sung
authors: Byung Seok
authors: BS
authors: Lee
authors: Hyun Yong
authors: HY
authors: Jeong
authors: Heon Young
authors: HY
authors: Lee
authors: Dae Young
authors: DY
authors: Kang
mesh_terms: D000199:Actins / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002166:Camptothecin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D003110:Colonic Neoplasms / Q000188:drug therapy*; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D006975:Hypertension, Portal / Q000209:etiology; D007150:Immunohistochemistry; D002955:Leucovorin / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D000077150:Oxaliplatin; D019408:Platelet Endothelial Cell Adhesion Molecule-1 / Q000378:metabolism; D013163:Splenomegaly / Q000175:diagnosis* / Q000209:etiology; D013921:Thrombocytopenia / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: C541116:ACTA2 protein, human; D000199:Actins; D009944:Organoplatinum Compounds; D019408:Platelet Endothelial Cell Adhesion Molecule-1; D000077150:Oxaliplatin; D002955:Leucovorin; D005472:Fluorouracil; D002166:Camptothecin
keywords: Liver Cirrhosis; Oxaliplatin; Splenomegaly