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Hepatic sinusoidal obstruction associated with S-1 plus cisplatin chemotherapy for highly advanced gastric cancer with paraaortic lymph node metastases: report of a case

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Abstract

A 56-year-old man who was diagnosed with gastric cancer with multiple paraaortic lymph node metastases was treated with S-1 plus cisplatin. The spleen gradually enlarged during the therapeutic courses. After the 6th course of therapy, the primary gastric lesion and paraaortic lymphadenopathies disappeared. He underwent a curative resection, including a distal gastrectomy with regional and paraaortic lymph node dissections. Irregularly distributed congestion of the liver was noted during the surgery. Histological examinations revealed residual cancer cells in 3 regional lymph nodes and no cancer cells in the primary site and paraaortic lymph nodes. Hepatic sinusoidal obstruction syndrome (SOS) was also confirmed histologically. This is the first report of a case with SOS after S-1 plus cisplatin therapy. S-1 plus cisplatin therapy can cause SOS, although it is a promising preoperative chemotherapy for highly advanced gastric cancer.

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Acknowledgments

We gratefully thank Dr. Katsuhiro Ogawa for his expert advice on the histological evaluation of the liver. We also thank Ms. Emi Hirakawa for her technical assistance.

Conflict of interest

The authors have no conflict of interest to declare.

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Authors and Affiliations

  1. Department of Surgery, Hokushinkai Megumino Hospital, 2-3-5 Megumino-Nishi, Eniwa, Hokkaido, 061-1395, Japan

    Hirofumi Toi, Susumu Shibasaki, Ichiro Tsuda, Takahisa Nakamura & Taiji Hase

  2. Department of Gastroenterology, Hokushinkai Megumino Hospital, 2-3-5 Megumino-Nishi, Eniwa, Hokkaido, 061-1395, Japan

    Yosuke Miura, Kenji Chisaka & Manabu Goto

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  1. Hirofumi Toi
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  2. Yosuke Miura
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  6. Ichiro Tsuda
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  7. Takahisa Nakamura
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Correspondence to Hirofumi Toi.

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Toi, H., Miura, Y., Shibasaki, S. et al. Hepatic sinusoidal obstruction associated with S-1 plus cisplatin chemotherapy for highly advanced gastric cancer with paraaortic lymph node metastases: report of a case. Clin J Gastroenterol 5, 341–346 (2012). https://doi.org/10.1007/s12328-012-0333-2

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  • DOI: https://doi.org/10.1007/s12328-012-0333-2

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