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Complete necrotization of hepatocellular carcinoma by chemotherapy and subsequent intravascular coagulation. A case report
Author(s) -
Harada Toshinori,
Makisaka Yasuharu,
Nishimura Hideo,
Okuda Kunio
Publication year - 1978
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(197807)42:1<67::aid-cncr2820420110>3.0.co;2-d
Subject(s) - medicine , hepatocellular carcinoma , disseminated intravascular coagulation , chemotherapy , autopsy , metastasis , pathology , carcinoma , angiography , radiology , cancer , gastroenterology
A 45‐year‐old man with hepatocellular carcinoma who developed intravascular coagulation following complete tumor regression by chemotherapy is described. After 2 doses of 10 mg of Mitomycin C given into the hepatic artery at the time of selective angiography, and 16 intravenous doses of 5‐fluorouracil and Mitomycin C, 2 doses per week, subjective symptoms and hepatomegaly disappeared. Alpha‐fetoprotein became negative and a remarkable change in tumor size and vasculature was noted in the arteriogram. Three months after chemotherapy, the patient developed thrombocytopenia, intravascular hemolysis, and acute renal failure. Autopsy disclosed a 8 × 7 × 5 cm solitary, encapsulated hepatocellular carcinoma in the right lobe. The tumor was surrounded by a thick capsule and completely necrotized. Neither intrahepatic invasion nor extrahepatic metastasis was observed. In the kidney, generalized fibrin thrombi were seen in the afferent arterioles of glomeruli as accounted for by intravascular coagulation.