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Tumor Rupture in a Patient with Recurrent Hepatocellular Carcinoma Following Atezolizumab plus Bevacizumab: A Case
Kazuhiro Tada1, Shohei Yoshiya1, Takaaki Mori2
1Department of Surgery, Oita Red Cross Hospital, Oita, Oita, Japan.
Introduction:
Atezolizumab plus bevacizumab combination therapy (atezo-bev) has been widely used worldwide as the first-line treatment for unresectable hepatocellular carcinoma (HCC). Intratumoral hemorrhage has been reported as a rare adverse event of atezo-bev. However, no previous cases of HCC rupture during atezo-bev have been reported. Herein, we demonstrate a case of tumor rupture in a patient with recurrent HCC following atezo-bev, who was successfully managed with transcatheter arterial embolization (TAE).
Case Presentation:
An 80-year-old man with multiple recurrent HCCs (at least 4 lesions with a maximum tumor diameter of 35 mm protruding from the liver surface) developed epigastralgia immediately after the first cycle of atezo-bev. CT revealed a ruptured HCC in the left lateral lobe. TAE was performed, and the patient continued to receive atezo-bev without any subsequent tumor bleeding.
Conclusions:
Tumor rupture should be considered in patients with HCC following atezo-bev treatment.
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