Uchida K, Ozono Y, Uchiyama N, Hatada H, Nakamura K, Komaki Y, Iwakiri H, Hasuike S, Nagata K, Sato Y, Kawakami H. Liver abscess in advanced hepatocellular carcinoma after atezolizumab plus bevacizumab treatment: A case report.
Medicine (Baltimore) 2022;
101:e30486. [PMID:
36107543 PMCID:
PMC9439774 DOI:
10.1097/md.0000000000030486]
[Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
RATIONALE
Hepatocellular carcinoma (HCC) is the sixth most common type of cancer globally. Since 2020, combination treatment with atezolizumab and bevacizumab were approved in patients with unresectable HCC in Japan, and atezolizumab plus bevacizumab is the first-line treatment for unresectable HCC.
PATIENT CONCERNS
A 73-year-old Japanese man diagnosed with a large HCC was treated with atezolizumab plus bevacizumab. After 2 cycles, he had fever and fatigue and was admitted to the hospital.
DIAGNOSIS
Abdominal contrast-enhanced computed tomography revealed tumor necrosis in HCC with gas formation in the necrotic area. Laboratory examination revealed a white blood cell (WBC) count of 16,340/μL and C-reactive protein (CRP) level of 33.0 mg/dL. Based on the above findings, he was diagnosed with a liver abscess.
INTERVENTIONS
Percutaneous transhepatic liver abscess drainage and broad-spectrum antibiotics treatment were performed.
OUTCOMES
Despite liver abscess drainage, persistent fever and no improvement in the WBC count or CRP level was observed. The patient's respiratory condition and renal function gradually worsened; The patient's general condition did not improve despite the ventilator support and continuous hemodiafiltration, and he died on day 37.
LESSONS
We report the first case of liver abscess after atezolizumab plus bevacizumab treatment for unresectable HCC.
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