Fulminant Hepatic Failure Secondary to Metastatic Prostate Cancer

Boyiadzis, Michael; Nam, Myung Jin; Dahut, William L.

doi:10.1159/000083293

Cited by 8 publications

(4 citation statements)

References 13 publications

(6 reference statements)

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“…Although uncommon, hepatic metastasis of prostate carcinoma has been reported. 22 In our patient, however, CT scans before and during his hospital admission were negative for liver metastasis. In addition, he had taken acetaminophen-containing analgesics before admission.…”

Section: Discussionmentioning

confidence: 46%

Bicalutamide‐Associated Fulminant Hepatotoxicity

2008

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Bicalutamide is a nonsteroidal antiandrogen used extensively during the start of androgen deprivation therapy with a luteinizing hormone-releasing hormone agonist to reduce occurrence of the symptoms of tumor flare in patients with metastatic prostate carcinoma. The most common adverse effects of bicalutamide are induced by its pharmacologic property of competitive androgen receptor blockade and include gynecomastia, hot flashes, fatigue, and decreased libido. Although not as common, increases in liver function test results are also seen with bicalutamide therapy. These elevations are typically transient, and patients remain asymptomatic. We describe a 59-year-old man with metastatic prostate carcinoma treated with bicalutamide as part of androgen deprivation therapy before starting chemotherapy. At baseline, his liver function test results and serum creatinine concentration were within normal limits, and an abdominal computed tomographic scan did not demonstrate liver metastasis. After 4 days of bicalutamide therapy, the patient came to the emergency department with complaints of abdominal pain, distension, and tenderness. His liver function tests were abnormal, and bicalutamide was discontinued. After 2 days of increasing liver function tests and symptoms of hepatotoxicity, the patient developed tachycardia and hypotension that was resistant to fluid resuscitation. Multiorgan damage was manifested by an alanine aminotransferase level greater than 40 times the upper limit of normal, serum creatinine concentration of 4.2 mg/dl, and troponin I level of 18 ng/ml. The patient died 8 days after bicalutamide therapy was begun secondary to multiorgan failure, most likely as a result of fulminant hepatotoxicity. The Naranjo adverse drug reaction probability scale showed a probable (score of 5) causal relationship between bicalutamide and fulminant hepatotoxicity. Fulminant hepatotoxicity is a rare but potentially fatal adverse effect of bicalutamide. Liver function tests should be monitored before and during bicalutamide therapy, even for patients who have previously completed a course of this therapy with no signs or symptoms of toxicity.

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Section: Discussionmentioning

confidence: 46%

Bicalutamide‐Associated Fulminant Hepatotoxicity

2008

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“…There are reports in literature of hematological [1][2][3][4][5][6][7] and non hematological malignancies [8][9][10][11][12][13][14][15][16][17] presenting as FHF. In a study of 4020 histological specimen of FHF, 0.44% showed evidence of a hematological malignancy.…”

Section: Discussionmentioning

confidence: 99%

Massive Infiltration of Liver by Metastatic Adenocarcinoma: A Rare Cause of Acute Hepatic Failure

Varghese

Venkataraman

Patra

et al. 2012

Journal of Clinical and Experimental Hepatology

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“…Extensive sinusoidal infiltration with malignant cells and progressive portal vein obstruction by tumor thrombus are the two pathways by which solid organ metastases cause ischemic necrosis of the liver (7). Other nonhematologic malignancies that may present in this manner include adenocarcinoma of the breast (8), prostate cancer (9), small‐cell carcinoma of lung (10), carcinoma of the urinary bladder (11), and malignant melanoma (12).…”

Section: Discussionmentioning

confidence: 99%