Department of Gastroenterology & Hepatology, Faculty of Medicine, Saitama Medical University, Japan.
Intern Med. 2022 Aug 1;61(15):2301-2305. doi: 10.2169/internalmedicine.8733-21. Epub 2022 Mar 12.
We herein report two patients with hepatocellular carcinoma (HCC) who exhibited intraabdominal bleeding caused by tumor rupture soon after lenvatinib initiation. A hypervascular nodule was present in the lateral segment manifesting extrahepatic protrusion in an 81-year-old-man and in the caudate lobe, which was completely occupied by the tumor, in an 83-year-old-man. Both patients were given lenvatinib, and epigastralgia occurred suddenly three and five days later. Computed tomography revealed high-attenuation areas suggesting bleeding around the left and caudate lobes. Considering the strong antiangiogenic effects by lenvatinib, transcatheter arterial embolization should be performed before lenvatinib initiation in patients with subcapsular HCC.
我们在此报告两例 HCC 患者，他们在仑伐替尼治疗开始后不久因肿瘤破裂而出现腹腔内出血。一位 81 岁男性的外侧段有一个富血管性结节，表现为肝外突出，一位 83 岁男性的尾状叶完全被肿瘤占据。两位患者均接受了仑伐替尼治疗，分别在治疗后 3 天和 5 天突发上腹痛。计算机断层扫描显示左叶和尾状叶周围有高浓度区域，提示出血。考虑到仑伐替尼强烈的抗血管生成作用，对于有包膜下 HCC 的患者，在开始仑伐替尼治疗前应进行经导管动脉栓塞术。
