Journal of

Case Reports and Images in Oncology

 
     
Case Report
 
A rare case of sorafenib induced liver injury in a patient with recurrent Hurthle cell carcinoma
Sufana Shikdar1, Oumoul Barry2, Eugene Choi2
1Resident Physician, Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA
2Attending Physician, Department of Hemato-Oncology, Mercy Catholic Medical Center, Darby, PA, USA

Article ID: 100051Z10SS2018
doi: 100051Z10SS2018

Corresponding Author:
Sufana Shikdar
1500 Lansdowne Ave, Darby, PA, USA

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How to cite this article
Shikdar S, Barry O, Choi E. A rare case of sorafenib induced liver injury in a patient with recurrent Hurthle cell carcinoma. J Case Rep Images Oncology 2018;4:100051Z10SS2018.


ABSTRACT

Introduction: Sorafenib (Nexavar ®), a multikinase inhibitor, has recently been approved by the FDA for metastatic, radio-resistant Hurthle Cell Carcinoma. Sorafenib induced liver injury is a rare side effect where the pathogenesis is still unknown. Multiple Sorafenib induced liver injury cases are reported, but the majority of the cases occur in the patient with hepatocellular or renal cell carcinoma. Sorafenib induced liver injury in terminally ill patients result in mortality, morbidity and poor quality of life outcome. Patients can be prematurely withdrawn or discontinued from the treatment due the adverse effects, which may limit the usefulness of this medication.

Case Report: We report a case of metastatic, radio-resistant Hurthle Cell Carcinoma (HCC) who was treated with Sorafenib. After one month of treatment, the patient required hospitalization for clinical and laboratory evidence of Drug Induced Liver Injury (DILI) due to Sorafenib. There was no prior history of hepatic pathology and detailed investigation was unremarkable. Her symptoms and liver function test improved within 10 days of discontinuing the drug. Unfortunately, she refused any further chemotherapy and elected hospice care for comfort measure.

Conclusion: Despite identification of the DILI, the pathophysiology and treatment options remain poorly understood. Timely diagnosis and appropriate treatment regarding Sorafenib induced liver injury is essential to improve patient’s quality of life and prevent mortality.

Keywords: Hepatotoxicity, Sorafenib, Thyroid cancer


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Acknowledgements
The authors are grateful to Dr. Ashley Lentini and Dr. Joseph Jaworski for their assistance with the image of histopathological slide.
Author Contributions
Sufana Shikdar – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Oumoul Barry –Substantial contributions to conception and design, Acquisition, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Eugene Choi – Substantial contributions to conception and design, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of Submission
The corresponding author is the guarantor of submission.
Source of Support
None
Consent Statement
Written informed consent was obtained from the patient for publication of this case report.
Conflict of Interest
Author declares no conflict of interest.
Copyright
© 2018 Sufana Shikdar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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