Harada T, Makisaka Y, Nishimura H, Okuda K
Cancer. 1978 Jul;42(1):67-73. doi: 10.1002/1097-0142(197807)42:1<67::aid-cncr2820420110>3.0.co;2-d.
A 45-year-old man with hepatocellular carcinoma who developed intravascular coagulation following complete tumor regression by chemotherapy is described. After 2 doses of 10 mg of Mitomycin C given into the hepatic artery at the time of selective angiography, and 16 intravenous doses of 5-fluorouracil and Mitomycin C, 2 doses per week, subjective symptoms and hepatomegaly disappeared. Alpha-fetoprotein became negative and a remarkable change in tumor size and vasculature was noted in the arteriogram. Three months after chemotherapy, the patient developed thrombocytopenia, intravascular hemolysis, and acute renal failure. Autopsy disclosed a 8 X 7 X 5 cm solitary, encapsulated hepatocellular carcinoma in the right lobe. The tumor was surrounded by a thick capsule and completely necrotized. Neither intrahepatic invasion nor extrahepatic metastasis was observed. In the kidney, generalized fibrin thrombi were seen in the afferent arterioles of glomeruli as accounted for by intravascular coagulation.
本文描述了一名45岁的肝细胞癌男性患者，其在化疗后肿瘤完全消退，随后发生了血管内凝血。在选择性血管造影时，经肝动脉给予2剂10mg丝裂霉素C，以及16剂静脉注射5-氟尿嘧啶和丝裂霉素C，每周2剂，患者的主观症状和肝肿大消失。甲胎蛋白转为阴性，动脉造影显示肿瘤大小和血管系统有显著变化。化疗3个月后，患者出现血小板减少、血管内溶血和急性肾衰竭。尸检发现右叶有一个8×7×5cm的孤立、有包膜的肝细胞癌。肿瘤被厚包膜包裹，完全坏死。未观察到肝内侵犯和肝外转移。在肾脏中，肾小球入球小动脉可见广泛的纤维蛋白血栓，这是由血管内凝血引起的。
