Fulminant Hepatic Failure Caused by Diffuse Liver Metastases following Gastrointestinal Stromal Tumor Resection

Clinical Medicine Insights: Gastroenterology

Case Report

Jochanan E. Naschitz¹  Eugene Vlodavsky²  Alicia Nachtigal³  Abdel-Rauf Zeina³ 

[1] Department of Internal Medicine A, Flieman Hospital, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.;Department of Pathology, Carmel Medical Center, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.;Department of Radiology, Hillel Yaffe Medical Center, Hadera, Israel. Affiliated to Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.;

关键词: gastrointestinal stromal tumor;    GIST;    fulminant hepatic failure;    liver metastasis;   

DOI  :  10.4137/CGast.S3221

来源: Sage Journals

【 摘 要 】

Metastatic tumors to the liver resulting in fulminant hepatic failure are a rare occurrence and have not been previously described in patients with gastrointestinal stromal tumor (GIST). A 70 year-old man was referred to hospital with postprandial discomfort. On examination a 19.5 cm large epithelioid GIST of the stomach was diagnosed. The mass exhibited unfavorable prognostic features: mitotic index 18/50 high-power fields, large primary tumor size and male sex. Complete tumor resection with negative margins was achieved and metastases were not detected. The patient presented six months later with jaundice, asterixis and elevated liver enzymes. Computerized tomography showed multiple liver hypodense lesions representing metastases. Treatment with imatinib mesylate was of no avail and the patient died 3 days later as the result of hepatic failure. Massive liver metastases can, even though rarely, be responsible for fulminant hepatic failure. Clinical and radiological follow-up are crucial in patients with GIST even after surgical resection.

【 授权许可】

CC BY   
© 2009 SAGE Publications.

【 图 表 】

Figure 2.