Fulminant hepatitis in a patient with hepatocellular carcinoma related to nonalcoholic steatohepatitis treated with sorafenib


We describe a case of acute liver failure in a patient with advanced hepatocellular carcinoma related to nonalcoholic steatohepatitis during sorafenib treatment. A 74-year-old man with diabetes mellitus and hypertension was diagnosed with hepatocellular carcinoma associated with fatty liver. Three weeks after sorafenib therapy, at Eastern Cooperative Oncology Group performance status 3, he developed jaundice, general weakness, flapping tremor, nausea, and anorexia. Sorafenib was stopped: laboratory tests showed a relevant elevation of transaminases suggesting diagnosis of acute hepatitis. During hospital admission, the patient died of liver failure. Sorafenib is the first successful target therapy effective for advanced hepatocellular carcinoma. The most common adverse events are fatigue, hand-foot skin reaction, skin rash/desquamation, diarrhea, and hypertension, whereas liver dysfunction is uncommon. To our knowledge, this is the first patient reported in the literature with hepatocellular carcinoma related to nonalcoholic steatohepatitis who died of rapid worsening of liver function during sorafenib treatment.

Tumori 2015; 101(2): e46 - e48

Article Type: CASE REPORT



Giovanni Brandi, Stefania De Lorenzo, Stefania Di Girolamo, Stefano Bellentani, Gioconda Saccoccio, Guido Biasco

Article History


Financial support: Volunteer Organizing Committee “Corri con Giò.”
Conflict of interest: The authors have no conflict of interest.

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  • Department of Experimental, Diagnostic and Specialty Medicine, Sant’Orsola Malpighi Hospital, University of Bologna, Bologna - Italy
  • “G. Prodi" Interdepartmental Center for Cancer Research (C.I.R.C.), University of Bologna, Bologna - Italy
  • Liver Center, Azienda USL Modena, “Ramazzini” Hospital, Carpi, Modena - Italy
  • Department of Medicine, Azienda USL Bologna, Bologna - Italy

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