Sinusoidal obstruction syndrome (veno-occlusive disease) in a patient receiving bevacizumab for metastatic colorectal cancer: A case report

被引：9
作者：
Agarwal V. [1 ,2 ,3 ,4 ,5 ,6 ]
Sgouros J. [1 ,2 ,3 ,4 ,5 ]
Smithson Jacqueline [1 ,2 ,3 ,4 ,5 ]
Lodge J.P.A. [1 ,2 ,3 ,4 ,5 ]
Razack A. [1 ,2 ,3 ,4 ,5 ]
Campbell A. [1 ,2 ,3 ,4 ,5 ]
Maraveyas A. [1 ,2 ,3 ,4 ,5 ]
机构：
[1] Academic Department of Oncology, Princess Royal Hospital, Hull
[2] Gastroenterology Department, Hull Royal Infirmary, Hull
[3] Hepatobiliary Unit, St James's University Hospital, Leeds
[4] Radiology Department, Castle Hill Hospital, Cottingham
[5] Department of Histopathology, Hull Royal Infirmary, Hull
[6] Princess Royal Hospital, Hull and East Yorkshire Hospitals NHS Trust, Hull HU8 9HE, Salthouse Road
来源：
Journal of Medical Case Reports | / 2卷 / 1期
关键词：
Bevacizumab; Oxaliplatin; Watchful Waiting; Oesophageal Varix; Sinusoidal Obstruction Syndrome;
D O I：
10.1186/1752-1947-2-227
中图分类号：
学科分类号：
摘要：
Introduction: We present the case of a patient with colon cancer who, while receiving bevacizumab, developed sinusoidal obstruction syndrome (veno-occlusive disease) (SOSVOD). Certain antitumour agents such as 6-mercaptopurine and 6-thioguanine have also been reported to initiate hepatic SOSVOD in isolated cases. There have been no reports so far correlating bevacizumab with SOSVOD. Case presentation: A 77-year-old man was being treated with oxaliplatin and a modified de Gramont regimen of 5-fluorouracil for metastatic colon cancer. Bevacizumab (7.5 mg/kg) was added from the seventh cycle onwards. Protracted neutropenia and thrombocytopenia led to discontinuation of oxaliplatin after the ninth cycle. A computed tomography scan showed complete response and bevacizumab was continued for another 3 months, after which time the patient developed right hypochondrial pain, transudative ascites, splenomegaly and abnormal liver function tests. Upper gastrointestinal endoscopy showed oesophageal varices. Liver biopsy showed features considered to be consistent with SOSVOD. Bevacizumab was stopped and a policy of watchful waiting was adopted. He tolerated the acute damage to his liver and subsequently the ascites resolved and liver function tests normalised. Conclusion: We need to beaware that bevacizumab can cause sinusoidal obstruction syndrome (veno-occlusive disease) and that the occurrence of ascites should not be attributed to progressive disease without appropriate evaluation. © 2008 Agarwal et al; licensee BioMed Central Ltd.
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