We experienced a case which was died of metabolic encephalopathy on the early course of oral treatment with sorafenib. The patient was 60's-year-old with advanced-stage of hepatocellular carcinoma. After 14 days of oral treatment with sorafenib, we found that the patient had disorientation and asterixis, which developed to deep coma, without serious hepatic failure. The patient died after 17 days of sorafenib treatment. We diagnosed as metabolic encephalopathy because he did not display obvious signs of hepatic failure. There was no factor which caused metabolic encephalopathy except for sorafenib administration. We have to consider the causal relationship between sorafenib administration and metabolic encephalopathy.
