• Internal medicine · Aug 2022

    Case Reports

    Two Cases of Intraabdominal Bleeding Caused by Hepatocellular Carcinoma Rupture Soon after the Initiation of Chemotherapy with Lenvatinib.

    • Aya Sato, Yukinori Imai, Hiroshi Uchiya, Yoshihito Uchida, Manabu Nakazawa, Kayoko Sugawara, Nobuaki Nakayama, and Satoshi Mochida.
    • Department of Gastroenterology & Hepatology, Faculty of Medicine, Saitama Medical University, Japan.
    • Intern. Med. 2022 Aug 1; 61 (15): 2301-2305.

    AbstractWe 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.

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