Li Xingxing
Department of Medical Oncology, The First People's Hospital of Linping District, Hangzhou, Zhejiang, China.
Medicine (Baltimore). 2025 Jun 20;104(25):e42991. doi: 10.1097/MD.0000000000042991.
The management of small cell lung cancer patients with acute hepatic failure presents significant challenges due to contraindications for standard chemotherapeutic agents.
A 72-year-old male with a history of colorectal cancer (postoperative status) was admitted to our hospital with malaise, nausea, and jaundice. During hospitalization, he exhibited persistently elevated and rapidly rising alanine aminotransferase and bilirubin levels, accompanied by clinical deterioration.
Primary small cell lung cancer with extensive hepatic metastases and hyperbilirubinemia was diagnosed, along with concurrent Epstein-Barr virus infection, confirmed through postoperative histopathological examination and ancillary diagnostic studies.
Following diagnosis, the patient underwent chemotherapy. Posttreatment laboratory monitoring demonstrated a progressive decline in both serum bilirubin levels and hepatic enzyme indices.
Exploring a balance between life-saving salvage therapy and respecting these contraindications is critical in optimizing outcomes for such high-risk oncology patients.
由于标准化疗药物存在禁忌证，小细胞肺癌合并急性肝衰竭患者的治疗面临重大挑战。
一名72岁男性，有结直肠癌病史（术后状态），因全身乏力、恶心和黄疸入住我院。住院期间，他的丙氨酸氨基转移酶和胆红素水平持续升高且迅速上升，同时临床症状恶化。
通过术后组织病理学检查和辅助诊断研究确诊为原发性小细胞肺癌伴广泛肝转移和高胆红素血症，同时合并爱泼斯坦-巴尔病毒感染。
确诊后，患者接受了化疗。治疗后实验室监测显示血清胆红素水平和肝酶指标均逐渐下降。
在为这类高危肿瘤患者优化治疗结果时，在挽救生命的挽救性治疗与尊重这些禁忌证之间寻求平衡至关重要。
