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Hepatocellular Carcinoma Rupture after Introducing Lenvatinib: An Autopsy Case Report.
Risako Kohya1, Ryo Sugiura1,2, Yoshiya Yamamoto1
1Department of Gastroenterology and Hepatology, Hakodate Municipal Hospital, Japan.
Internal Medicine (Tokyo, Japan)
|September 1, 2022
Summary
Lenvatinib treatment for hepatocellular carcinoma (HCC) can rarely cause fatal hemorrhaging. Autopsy revealed widespread tumor bleeding, suggesting lenvatinib as the cause in this patient.
Area of Science:
- Hepatocellular carcinoma (HCC) research
- Oncology
- Pharmacology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer.
- Lenvatinib is a targeted therapy used for HCC treatment.
- Hemorrhage or rupture of HCC is a rare but serious complication.
Observation:
- A 69-year-old male patient with HCC experienced cardiac arrest 7 days after initiating lenvatinib therapy.
- An autopsy revealed a large tumor with internal cracking and coagulated blood.
- Hemorrhagic areas were pathologically observed throughout most HCC lesions, irrespective of tumor differentiation.
Findings:
- The widespread pathological hemorrhaging pattern observed in the HCC lesions was atypical for untreated HCC.
- The timing of the event, shortly after lenvatinib initiation, strongly suggests a causal link.
Implications:
- This case highlights a rare but potentially fatal adverse effect of lenvatinib in HCC patients.
- Increased vigilance for hemorrhagic complications during lenvatinib therapy is warranted.
- Further pathological studies are needed to understand the mechanism of lenvatinib-induced HCC hemorrhage.
