2021 Volume 62 Issue 1 Pages 1-7
A 66-year-old male patient received systemic chemotherapy for metastatic colon cancer. During the introduction of the 38th dose of the 5-FU based regimen (5FU+folinic acid+irinotecan), he exhibited general fatigue followed by acute steatosis with liver dysfunction, accompanied by a steep decline of serum albumin and ascites formation. After cessation of the chemotherapeutic drug and receiving supportive care for hepatic dysfunction, the hepatic dysfunction rapidly improved. Following this episode, the effective chemotherapy continued for 32 months, until the patient's death due to interstitial pneumonia (The entire survival time was 68 months.). The regeneration of the hepatic volume was normal following three hepatectomies for his liver metastases. The histological findings harvested 12 months prior to the hepatic failure presented almost normal parenchyma of the background liver. Although irinotecan was the most suspicious cause for the steatosis, an acute form of the hepatic failure has hardly been reported before this case.
