A 69-year-old male patient with a history of colon cancer and liver metastases (LBM) in 2004.
He underwent surgery, performing right hemicolectomy, resection and radiofrequency of liver lesions.
Intraoperative biopsy analyzed fragments of liver described.
Three weeks after surgery the patient begins chemotherapy consisting of cetuximab, oxaliplatin (OX), 5 flurouracil (5-FU) and leucovorin (LV) every two weeks.
Due to the favorable evolution of the patient, OX and VL are removed at the sixth cycle of chemotherapy.
Two months later a new diagnosis of colitis was established, which recurred bimonthly. After six cycles, the patient underwent left hepatic lobectomy.
Microscopic examination of the biopsy showed that the rest of the liver parenchyma had preserved architecture.
Due to recurrence, the regimen is changed to 5 FU, irinotecan (I) and beizumab (B), which was administered every two weeks.
A twelfth cycle I was eliminated from therapy due to good response and the remaining two agents were continued.
After eleven cycles of chemotherapy, the patient had partial thrombosis of the portal vein (PVT) in computed axial tomography (CAT).
After oral anticoagulation with acenocoumarol for five months, the patient restarted chemotherapy with B, performing 19 cycles more.
1.
The year 2008 was surveyed for esophageal varices grade 2 in Baveno, through upper endoscopy.
A CT scan showed the development of portosystemic collateral circulation, with repermeabilization of the umbilical vein and multiple collaterals in splenic hilium, perigastric and periesophageal flow.
Liver tests were normal.
Liver biopsy was performed for etiologic study.
Biopsy reported NRH.
