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Oxaliplatin toxicity presenting as a liver nodule - case report
Henrique Alexandrino1,2, Domingos Oliveira3, Maria Augusta Cipriano4
1Department of General Surgery, Coimbra University Hospital, Coimbra, Portugal. halexandrino123@gmail.com.
BMC Cancer
|April 18, 2015
Summary
Oxaliplatin chemotherapy can cause liver nodules that mimic metastases in colon cancer patients. Early imaging and biopsy are crucial to avoid unnecessary surgery for Sinusoidal Obstruction Syndrome.
Area of Science:
- Oncology
- Hepatology
- Gastroenterology
Background:
- Oxaliplatin is a key chemotherapy agent for adjuvant therapy in colon and rectal cancers.
- Sinusoidal Obstruction Syndrome (SOS) is a rare but serious side effect of oxaliplatin treatment.
- SOS can manifest as liver nodules that are radiologically indistinguishable from metastases.
Observation:
- A 59-year-old man with stage III colon cancer developed a liver nodule after oxaliplatin chemotherapy.
- The patient underwent a right hepatectomy due to suspicion of liver metastasis.
- Pathological examination revealed Sinusoidal Obstruction Syndrome, not malignancy.
Findings:
- This case represents the third documented instance of oxaliplatin-induced SOS mimicking liver metastasis.
- The liver lesion was confirmed to be a consequence of oxaliplatin toxicity, not metastatic disease.
- Surgical resection was performed, and pathological diagnosis confirmed SOS.
Implications:
- In patients treated with oxaliplatin presenting with new liver nodules, SOS should be strongly considered in the differential diagnosis.
- Advanced imaging and potentially preoperative biopsy are recommended to accurately diagnose liver lesions in this patient population.
- Distinguishing SOS from metastases is critical to prevent overtreatment and guide appropriate patient management.
