A case of biliary bleeding due to perforation of the gallbladder by a tumor that was caused immediately after combination therapy of atezolizumab and bevacizumab for advanced hepatocellular carcinoma

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  • Shoji Yukako
    Department of Hepatro-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center Department of Gastroenterology, Fukuoka Tokushukai Hospital
  • Senju Takeshi
    Department of Hepatro-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center Department of Gastroenterology, Kyushu Rosai Hospital
  • Morita Yusuke
    Department of Hepatro-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center
  • Tanaka Yuki
    Department of Hepatro-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center
  • Sugimoto Rie
    Department of Hepatro-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center

Bibliographic Information

Other Title
  • 進行肝細胞癌に対するアテゾリズマブ＋ベバシズマブ併用療法開始直後に発症した腫瘍の胆囊穿破による胆道出血の1例
  • シンコウ カン サイボウ ガン ニ タイスル アテゾリズマブ+ベバシズマブ ヘイヨウ リョウホウ カイシ チョクゴ ニ ハッショウ シタ シュヨウ ノ タンノウセンハ ニ ヨル タンドウ シュッケツ ノ 1レイ

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Abstract

<p>We present a case of biliary bleeding caused by gallbladder perforation caused by a tumor that occurred immediately after combination therapy with atezolizumab and bevacizumab for advanced hepatocellular carcinoma. The male patient in his 70s with advanced hepatocellular carcinoma was treated with combination therapy of atezolizumab and bevacizumab on day 1 and experienced epigastralgia on day 2. On day 3, we determined that biliary obstruction had occurred due to biliary bleeding caused by gallbladder perforation caused by the tumor, and we performed biliary drainage via emergency endoscopic retrograde cholangiopancreatography. To treat tumor bleeding from the tumor, we used hepatic artery embolization of tumor blood vessel A6 on day 6. Bevacizumab was thought to have caused the biliary hemorrhage, so the combination therapy of atezolizumab and bevacizumab was stopped, lenvatinib was introduced, and subsequent CT revealed tumor shrinkage.</p>

Journal

  • Kanzo

    Kanzo 64 (10), 497-503, 2023-10-01

    The Japan Society of Hepatology

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