Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019209 (hepatomegaly)
 5,798 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Four cases of hepatic angiosarcoma are reported with a review of 99 other cases in the English literature. Angiosarcoma of the liver is associated with chronic exposure to thorotrast, vinyl chloride, arsenicals, radium and possibly copper and with chronic idiopathic hemochromatosis. Although 40% of patients have hepatic fibrosis or cirrhosis at autopsy, the nature of the association between chronic liver disease and hepatic angiosarcoma is unknown. The clinical presentation of hepatic angiosarcoma is nonspecific with abdominal pain, weakness and weight loss common complaints and with hepatomegaly, ascites and jaundice common findings. Liver function tests are usually abnormal but there is no one liver function test or set of tests specific for the tumor. The occurrence of thrombocytopenia and disseminated intravascular coagulation is characteristic of hepatic angiosarcoma and may be related to local consumption of clotting factors and formed blood elements in the tumor. Catastrophic intraabdominal bleeding is also characteristic and occurs in one-fourth of all cases. This complication is likely related to the high incidence of clotting abnormalities and the vascular nature of the neoplasm. Selective hepatic arteriogram and open liver biopsy are the foundations of diagnostic evaluation. Percutaneous liver biopsy should be avoided. Failure to appreciate the possibility of hepatic angiosarcoma in the proper clinical setting, leading to blind percutaneous biopsy, may result in failure to make the diagnosis at the cost of significant morbidity and mortality. Survival of patients with hepatic angiosarcoma is brief; only 3% live longer than 2 years. Treatment of the tumor to date is empirical. There are probably a few patients who might benefit from radical surgery with curative intent. For all others chemotherapy is indicated. Adriamycin is active against hepatic angiosarcoma, but optimal dose and mode of administration require further investigation. Further study is also required to delineate the cause of hepatic angiosarcoma in the 60% of cases without definite epidemiologic association.
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PMID:The clinical features of hepatic angiosarcoma: a report of four cases and a review of the English literature. 36 8

A 10-month-old boy was noted to have hepatomegaly, and hepatic angiography showed a huge tumor of the medial segment of the left lobe, located close to the hepatic hilum and involving the anterior segment of the right lobe in contiguity. We considered at first that resection would not be possible, but at operation the anterior segmental branch of the right hepatic artery was successfully ligated and divided, which made left trisegmentectomy possible in this case. Postoperatively, the patient was treated with cisplatin and tetrahydropyranyl Adriamycin he was doing well without any evidence of disease 24 months after the hepatectomy.
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PMID:Left hepatic trisegmentectomy for interlobar hepatoblastoma located close to the hepatic hilum. 255 10

From 1976 to 1983, 28 patients (24 male and four female) with unresectable hepatocellular carcinoma (HCC) were treated by intraarterial chemotherapy at the Istituto Nazionale Tumori of Milan, Milan, Italy. Tumors were retrospectively classified by a previously proposed staging system. Two patients were classified as Stage I and 26 as Stage II. Liver cirrhosis was present only in the males (in 50% of them). Nineteen patients were treated with doxorubicin (Adriamycin [Adria Laboratories, Columbus, OH]) and nine with 5-fluorouracil. Systemic toxicity was mild, but the treatment induced hepatic toxicity (ascites, clinical jaundice, or biochemical impairment) in 18% of noncirrhotic and 66% of cirrhotic patients. Clinical reduction of hepatomegaly was observed in 50% of noncirrhotic versus 16% of cirrhotic patients. Doxorubicin was effective in 66% of noncirrhotic patients and 20% of cirrhotic patients, with an overall response rate of 42%. 5-fluorouracil was effective only in patients without cirrhosis, with an overall response rate of 22%. Overall median actuarial survival was 3.5 months, with a significant difference between noncirrhotic and cirrhotic patients (6 versus 2 months, respectively). Overall median survival of patients who responded to the treatment was 13 versus 2 months for nonresponders (P less than 0.001). Liver cirrhosis was the most important prognostic factor in terms of liver toxicity, response rate, and survival. This study emphasized the negative impact of the treatment on cirrhotic patients. Also, the real value of intraarterial administration of doxorubicin was investigated.
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PMID:Intrahepatic chemotherapy for unresectable hepatocellular carcinoma. 283 36

A 68-year-old man was referred to our hospital because of generalized lymphadenopathy. His abnormal findings were hepatomegaly, leukocytosis and elevated serum LDH. Anti-ATLA antibody was positive. As about half of the peripheral lymphocytes reacted to the monoclonal antibody CD25, these cells were considered to be compatible with ATL cells having an interleukin-2 receptor. Initially, recombinant beta-interferon was administered, but it was not effective. A combination of vincristine (VCR) and prednisolone (PDN) was partially effective against the lymphadenopathy, but the hepatomegaly and leukocytosis did not improve. 4'-epi-Adriamycin (Epirubicin), at a doses of 20 mg/body, weekly, was subsequently added to VCR + PDN therapy. The patient achieved complete regression 2 months later, and has been in continuous complete remission for more than 3 months.
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PMID:[A case of adult T-cell leukemia achieving complete remission with epirubicin, vincristine and prednisolone chemotherapy]. 288 35

Doxorubicin (DXR; Adriamycin) was administered i.v. to 20 Sprague-Dawley rats at 2.5 mg/kg once a week for 8 weeks. The rats were then observed for 2 to 5 weeks post treatment until they developed signs of general and cardiotoxicity (lassitude, ascites, marked ECG changes), at which time 11 of these animals and 11 age-matched controls were killed for evaluation of isometric contractile activity changes in isolated right ventricular papillary muscles. At necropsy the animals were examined for evidence of congestive heart failure (enlarged liver, s.c. edema). Baseline contractile changes in preparations from DXR-treated rats, compared with controls, were a decrease in maximum rate of tension development and prolongation in time to peak tension, time to half-relaxation from peak tension and duration of tension. Both developed tension and tension duration in the DXR-exposed muscles were reduced less than those in controls by a decrease in the stimulus interval, and some DXR preparations exhibited a positive staircase rather than the negative staircase normally observed in rats. Increasing extracellular Ca++ produced substantially greater changes in peak tension and maximum rate of tension development, as well as time to half-relaxation and tension duration in the DXR muscles; however, the effects of isoproterenol on these four parameters were blunted in the DXR muscles (although decreased isoproterenol sensitivity was borderline in the case of tension duration and time to half-relaxation). The results suggest that long-term DXR treatment leads to a loss of adrenergic support in the rat heart, and that calcium deficiency, rather than overload, occurs in cells that are still functionally active.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Doxorubicin cardiotoxicity: contractile changes after long-term treatment in the rat. 394 92

BACKGROUND Hepatic metastasis is well known in breast cancer. Approximately 12-20% of breast cancer patients will develop liver metastasis, which usually presents as discrete mass lesions. Rarely, metastatic spread can be so diffuse that it is unidentifiable on imaging but can progress to fulminant hepatic failure. Our case report suggests that clinicians need to have a high index of suspicion when patients present with rapidly decompensating liver failure in the absence of discrete radiologic hepatic lesions, and that weekly Adriamycin should be considered as a first-line therapeutic option. CASE REPORT A 28-year-old African American woman with a history of locally advanced estrogen receptor-positive, progesterone receptor-negative, and HER2-negative breast cancer presented with right upper quadrant abdominal pain and bilateral lower extremity swelling. She had been treated 3 years prior with neoadjuvant Adriamycin/cyclophosphamide - Taxol, bilateral mastectomies, radiation therapy, and tamoxifen. Diagnostic imaging revealed massive hepatomegaly and extensive areas of liver ischemia/necrosis without discrete masses or arterial/venous thrombosis. Biopsy of the liver revealed metastatic carcinoma diffusely infiltrating the hepatic sinusoids. Extensive work up for other etiologies of liver disease was negative. The patient's liver function quickly decompensated over several days. She was treated with weekly single-agent low-dose Adriamycin, and this resulted in successful reversal of her liver function tests back to baseline. CONCLUSIONS In addition to having a high index of suspicion for diffuse intrasinusoidal hepatic metastasis, physicians should consider weekly low-dose Adriamycin as a first-line therapeutic option for patients with progressive liver failure and biopsy-confirmed metastatic carcinoma diffusely infiltrating the hepatic sinusoids.
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PMID:Diffuse Intrasinusoidal Hepatic Metastasis from Breast Cancer Presenting as Liver Failure: Effective and Rapid Treatment with Weekly Low-Dose Adriamycin. 3287 89