title: Oxaliplatin-induced sinusoidal obstruction syndrome mimicking metastatic colon cancer in the liver.
abstract: Oxaliplatin is an effective chemotherapeutic agent for the treatment of colorectal cancer; however, it may cause liver injury, particularly sinusoidal obstruction syndrome (SOS). Although SOS does not usually present with focal lesions on radiological images, the present study describes the case of a 22-year-old woman with oxaliplatin-induced SOS mimicking metastatic colon cancer in the liver. An abdominal computed tomography revealed a novel 1 cm, low-density lesion in segment 1 of the liver following the administration of the fourth round of oxaliplatin-based adjuvant chemotherapy for stage III colon cancer. Since the lesion was indistinguishable from metastasis, even with detailed imaging studies, including magnetic resonance imaging and positron emission tomography-computed tomography, an isolated caudate lobectomy was planned. The cut surface of the resected liver showed a localized reddish congested lesion measuring 1.4 cm in diameter. The adjacent hepatic parenchyma also demonstrated diffuse sinusoidal congestion with a nutmeg-like appearance. Histologically, the lesion exhibited severe sinusoidal congestion with peliosis hepatis-like features. The widened sinusoidal space was outlined by markedly attenuated hepatic cords and filled with erythrocytes. The final diagnosis was oxaliplatin-induced SOS. The patient recovered completely and was relapse-free at the time of writing.
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Gyeonggi 471-701, Republic of Korea.
authors.forename: Jung-Hye
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Gyeonggi 471-701, Republic of Korea.
authors.forename: Young-Woong
authors.initials: YW
authors.lastname: Won
authors.affiliation: Department of Pathology, Hanyang University Guri Hospital, Guri, Gyeonggi 471-701, Republic of Korea.
authors.forename: Hyun Sung
authors.initials: HS
authors.lastname: Kim
authors.affiliation: Department of Pathology, Hanyang University Guri Hospital, Guri, Gyeonggi 471-701, Republic of Korea.
authors.forename: Young-Ha
authors.initials: YH
authors.lastname: Oh
authors.affiliation: Department of Radiology, Hanyang University Guri Hospital, Guri, Gyeonggi 471-701, Republic of Korea.
authors.forename: Sanghyeok
authors.initials: S
authors.lastname: Lim
authors.affiliation: Department of Surgery, Hanyang University Guri Hospital, Guri, Gyeonggi 471-701, Republic of Korea.
authors.forename: Han-Joon
authors.initials: HJ
authors.lastname: Kim
keywords: colon cancer; oxaliplatin; sinusoidal obstruction syndrome