[Two cases of esophageal variceal rupture associated with chemotherapy for liver metastasis of breast cancer].
A morphological change resembling liver cirrhosis called pseudocirrhosis may be observed following chemotherapy for liver metastasis of breast cancer. Pseudocirrhosis is hypothesized to be caused by retraction of the hepatic capsule along with tumor shrinkage and subsequent scar formation around the metastatic lesion, as a response to the infiltrating tumor or chemotherapy-induced hepatic injury. The progression of cirrhotic changes may result in portal hypertension and esophageal varices. We managed two cases of esophageal variceal rupture during chemotherapy for breast cancer with liver metastasis. Hemostasis was successfully achieved by the endoscopic variceal ligation technique in both cases. We conclude that clinicians should be aware of the risk of pseudocirrhosis during chemotherapy for liver metastasis, and a periodic endoscopic follow-up is recommended along with appropriate management of esophageal varices.
Dept. of Surgery, Ohno Memorial Hospital.
Yoko
Y
Mizuyama
Osamu
O
Shinto
Sinji
S
Matsutani
Yuichi
Y
Arimoto
Hiroji
H
Nakagawa
Yoshioki
Y
Ohno
Tsutomu
T
Takashima
D000328:Adult; D000368:Aged; D017542:Aneurysm, Ruptured / Q000139:chemically induced / Q000601:surgery*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects* / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D004932:Esophageal and Gastric Varices / Q000473:pathology* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000188:drug therapy* / Q000556:secondary