EP112 – A rare case of sorafenib induced liver Injury in a patient with recurrent hurthle cell cancer

      Shikdar, Sufana1; Barry, Oumoul2; Choi,Eugene3 1 Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA 2 Department of Internal Medicine, Mercy Catholic Medical Center, Darby, PA, USA 3 Department of Hemato-Oncology, Mercy Catholic Medical Center, Darby, PA, USA   Background: 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 Patients can be prematurely withdrawn or discontinued from the treatment due to the adverse effects, which may limit the usefulness of this medication. Case Presentation: We report a case of metastatic, radioresistant Hurthle Cell Carcinoma (HCC) who was treated with Sorafenib. After 1 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 investigations were 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 the identification of the DILI, the pathophysiology and treatment options remain poorly understood. Timely diagnosis and appropriate treatment regarding Sorafenib induced liver injury is imperative to improve patient’s quality of life, and prevent mortality.   References:
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