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Oxaliplatin-Induced Sinusoidal Obstruction Syndrome Masquerading as Colorectal Liver Metastasis: A Case Report

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Abstract

Introduction

Oxaliplatin-based chemotherapy is commonly used in adjuvant treatment of colon cancer as well as in neoadjuvant setting in patients with liver metastases. However oxaliplatin can cause damage to non-tumor bearing liver which presents as sinusoidal obstructive syndrome (SOS). These changes are difficult to differentiate from metastasis clinic-radiologically and manifests as sinusoidal dilatation, peliosis and nodular regenerative hyperplasia.

Case

The present study reports the case of a patient with oxaliplatin-induced SOS which mimicked colo-rectal liver metastasis on follow up imaging studies after receiving neoadjuvant oxaliplatin based chemotherapy. After multidisciplinary discussion, patient was planned for simultaneous resection of rectal primary and right hepatectomy for metastasis. Final histopathology revealed no tumour in liver but the liver lesions seen radiologically were actually changes of oxaliplatin induced focal SOS and mimicked metastatic nodules.

Conclusion

In patients with colo-rectal cancer having received oxaliplatin-based chemotherapy, SOS may be considered as one of the causes of newly developed liver lesions, and should be subjected to additional radio-pathologic evaluation to prevent overtreatment and avoiding potentially morbid surgeries.

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Data Availability

The datasets generated during and/or analysed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Surgical Oncology, Tata Memorial Hospital, Homi Bhabha National Institute, Ernest Borges Road, Parel, Mumbai, 400012, India

    Vipul Gupta, Amit Chopde, Shraddha Patkar & Mahesh Goel

  2. Department of Pathology, Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai, India

    Kedar Deodhar

Authors
  1. Vipul Gupta
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  2. Amit Chopde
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  3. Shraddha Patkar
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  4. Kedar Deodhar
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  5. Mahesh Goel
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Shraddha Patkar, Vipul Gupta and Amit Chopde. The first draft of the manuscript was written by Vipul Gupta and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Shraddha Patkar.

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The study is compliant with ethical standards. Written informed consent was obtained from the patient for the surgery.

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The authors declare no competing interests.

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Gupta, V., Chopde, A., Patkar, S. et al. Oxaliplatin-Induced Sinusoidal Obstruction Syndrome Masquerading as Colorectal Liver Metastasis: A Case Report. J Gastrointest Canc 54, 682–686 (2023). https://doi.org/10.1007/s12029-022-00835-x

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  • DOI: https://doi.org/10.1007/s12029-022-00835-x

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