Reactions 1460, p33 - 13 Jul 2013 S Oxaliplatin Focal sinusoidal obstruction syndrome: case report A 40-year-old woman developed focal sinusoidal obstruction syndrome (SOS) while receiving oxaliplatin. The woman, who had previously undergone curative low anterior resection for advanced rectal cancer, was admitted. She had received XELOX postoperative adjuvant chemotherapy as eight cycles of a 21-day regimen, consisting of capecitabine and a 2-hour IV infusion of oxaliplatin 130 mg/m 2 per day on day 1 [time to onset not stated]. Tests revealed a WBC of 2900/mm 3 , a haemoglobin level of 12.1 g/dL and a platelet count of 12.8 × 10 4 /mm 3 . A contrast- enhanced CT scan in the arterial phase showed three hypodense masses with border irregularities in the right lobe of the liver. In the portal and venous phases, heterogeneous enhanced parts were seen in the tumours. Apparent splenomegaly was also observed. B-mode ultrasonography showed three hyperechoic lesions. Gadoxetic acid-enhanced MRI revealed the lesions as hypointense tumours relative to the surrounding parenchyma. Preoperative imaging findings were compatible with metastatic liver tumours from rectal cancer. The woman underwent right hepatic lobectomy. The resected specimens consisted of three hepatic tumours that were dark red and soft. Histopathology revealed sinusoidal dilation and severe congestion outlined by atrophic hepatocyte trabeculae, known as peliosis hepatis. The perisinusoidal space of Disse was extensively dilated and contained many erythrocytes. The hepatic tumours were considered to be space-occupying lesions resulting from focal SOS. At last follow-up, she was well, without evidence of recurrence. Author comment: "We herein report a case of oxaliplatin- related SOS mimicking metastatic liver tumor." Arakawa Y, et al. Oxaliplatin-related sinusoidal obstruction syndrome mimicking metastatic liver tumors. Hepatology Research 43: 685-689, No. 6, Jun 2013. Available from: URL: http://dx.doi.org/10.1111/j.1872-034X.2012.01114.x - Japan 803089669 1 Reactions 13 Jul 2013 No. 1460 0114-9954/13/1460-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved

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Reactions 1460, p33 - 13 Jul 2013

SOxaliplatin

Focal sinusoidal obstruction syndrome: case reportA 40-year-old woman developed focal sinusoidal

obstruction syndrome (SOS) while receiving oxaliplatin.The woman, who had previously undergone curative low

anterior resection for advanced rectal cancer, was admitted.She had received XELOX postoperative adjuvantchemotherapy as eight cycles of a 21-day regimen, consistingof capecitabine and a 2-hour IV infusion of oxaliplatin130 mg/m2 per day on day 1 [time to onset not stated]. Testsrevealed a WBC of 2900/mm3, a haemoglobin level of12.1 g/dL and a platelet count of 12.8 × 104/mm3. A contrast-enhanced CT scan in the arterial phase showed threehypodense masses with border irregularities in the right lobeof the liver. In the portal and venous phases, heterogeneousenhanced parts were seen in the tumours. Apparentsplenomegaly was also observed. B-mode ultrasonographyshowed three hyperechoic lesions. Gadoxetic acid-enhancedMRI revealed the lesions as hypointense tumours relative tothe surrounding parenchyma. Preoperative imaging findingswere compatible with metastatic liver tumours from rectalcancer.

The woman underwent right hepatic lobectomy. Theresected specimens consisted of three hepatic tumours thatwere dark red and soft. Histopathology revealed sinusoidaldilation and severe congestion outlined by atrophic hepatocytetrabeculae, known as peliosis hepatis. The perisinusoidalspace of Disse was extensively dilated and contained manyerythrocytes. The hepatic tumours were considered to bespace-occupying lesions resulting from focal SOS. At lastfollow-up, she was well, without evidence of recurrence.

Author comment: "We herein report a case of oxaliplatin-related SOS mimicking metastatic liver tumor."Arakawa Y, et al. Oxaliplatin-related sinusoidal obstruction syndrome mimickingmetastatic liver tumors. Hepatology Research 43: 685-689, No. 6, Jun 2013.Available from: URL: http://dx.doi.org/10.1111/j.1872-034X.2012.01114.x -Japan 803089669