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Vol. 5, No. 3, 2012
Issue release date: September – December
Section title: Published: December 2012

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Case Rep Oncol 2012;5:644–650
(DOI:10.1159/000345956)

Gastroesphageal Variceal Hemorrhage Induced by Metastatic Liver Tumor of Lung Cancer

Honda T.a · Kobayashi H.a · Saiki M.a · Sogami Y.a · Miyashita Y.a · Inase N.b
aDepartment of Respiratory Medicine, Yamanashi Prefectural Central Hospital, Kofu, and bDepartment of Integrated Pulmonology, Tokyo Medical and Dental University, Tokyo, Japan
email Corresponding Author

Takayuki Honda

Department of Respiratory Medicine

Yamanashi Prefectural Central Hospital

Fujimi 1-1-1, Kofu 400-0027 (Japan)

E-Mail honda-bdhh@ych.pref.yamanashi.jp

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Abstract

Gastroesophageal variceal hemorrhage is a lethal complication of portal hypertension. Liver cirrhosis is often the principal cause of the portal hypertensive state. Malignant tumors coexist with portal hypertension in some cases. Non-small-cell lung cancer (NSCLC) is likely to become metastatic. Liver is a frequent site of cancer metastasis, but diffuse hepatic sinusoidal metastasis is uncommon as a metastatic form of NSCLC. This report describes a patient with gastroesophageal variceal hemorrhage owing to a metastatic liver tumor of NSCLC. The patient, a male smoker with stage IV NSCLC, was free of any hepatitis viral infection and had no alcohol addiction. Liver dysfunction and liver disease had never been pointed out in his medical history. His tumor harbored an L858R epidermal growth factor receptor mutation. Gefitinib was initiated but had to be ceased because of interstitial lung disease. Sequential steroid therapy was effective and bevacizumab-containing chemotherapy was commenced. Both chemotherapy regimens produced favorable effects against the metastatic liver tumor, eliciting atrophic change regardless of the chemotherapy-free interval. One day the patient was admitted to our hospital because of black stool and hypotension. Upper gastrointestinal endoscopy revealed a beaded appearance of the gastroesophageal varix with bloody gastric contents. The portal hypertension might have been caused by changes in portal vein hemodynamics induced by the conformational changes underlying the favorable response of the liver tumor to molecular targeted chemotherapy and notable regression.

© 2012 S. Karger AG, Basel


Article / Publication Details

First-Page Preview
Abstract of Published: December 2012

Published online: 12/6/2012
Issue release date: September – December

Number of Print Pages: 7
Number of Figures: 3
Number of Tables: 0

ISSN: (Print)
eISSN: 1662-6575 (Online)

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