[Dacarbazine in malignant melanoma. Rare, severe side-effect: Budd-Chiari-syndrome (author's transl)]

Dacarbazine (DTIC) alone or in combination with other cytostatic drugs may lead to severe liver disease with acute thrombosis of intrahepatic veins and parenchymal cell necrosis. 6 such cases were described in the literature, an additional case is described here, all with fatal outcome. 6 of these 7 patients had malignant melanoma. The disease has been partly designed as Budd-Chiari-Syndrome (BCS), partly as veno-occlusive disease (VOD).-The pathoanatomical findings and the appearance of the clinical symptoms exclusively during the 2nd injections series suggest a Budd-Chiari-Syndrome, in terms of an allergic-hyperergic reaction of the liver as target organ. For future administration of Dacarbazine in malignant melanoma (a) patients with pre-existent liver disease should be excluded from DTIC-treatment, (b) the prodromi and cardinal symptoms should be carefully registered and (c) high dosage corticosteroid therapy with fibrinolytic measures should be immediately administered.