内容紹介
A Case of Wilson's Disease with Psoriasis Vulgaris, Complicated with Hepatocellular Carcinoma and Successfully Treated with Sorafenib
Summary
A 55-year-old man had been diagnosed with Wilson's disease and was treated with D-penicillamine 36 years earlier. He also had a 20-year history of psoriasis vulgaris and cyclosporine treatment. In 2012, a he presented with a hepatocellular carcinoma(HCC)that was removed via partial hepatic resection. In 2014, multiple HCC and a portal vein tumor thrombus were found in his posterior lobe. Sorafenib treatment was initiated. Cyclosporine treatment was continued. Three months later, abdominal enhanced CT revealed marked tumor reduction and shrinkage of the portal vein tumor thrombus. The therapeutic effect of sorafenib continued for 6 months. We did not observe deterioration in his psoriasis vulgaris and Wilson's disease for 9 months after sorafenib initiation.
要旨
症例は55歳,男性。19歳時にWilson病と診断され,D-ペニシラミンによる治療が開始となった。35歳から尋常性乾癬にてシクロスポリンの投与を受けていた。2012年,肝細胞癌(HCC)に対し肝部分切除術を施行した。2014年に腰背部痛があり,腹部造影CT検査にて肝後区域に右門脈腫瘍栓を伴う多発腫瘍を認めた。多発再発HCCと診断し,ソラフェニブによる治療を開始した。ソラフェニブ開始後も,D-ペニシラミンとシクロスポリンは継続投与した。ソラフェニブ開始3か月後と6か月後に施行した造影CT検査では,肝後区域の腫瘍と門脈腫瘍栓は著明に縮小していた。ソラフェニブ投与開始後9か月現在,尋常性乾癬とWilson病の症状は悪化なく,ソラフェニブによる治療を継続している。
目次
Summary
A 55-year-old man had been diagnosed with Wilson's disease and was treated with D-penicillamine 36 years earlier. He also had a 20-year history of psoriasis vulgaris and cyclosporine treatment. In 2012, a he presented with a hepatocellular carcinoma(HCC)that was removed via partial hepatic resection. In 2014, multiple HCC and a portal vein tumor thrombus were found in his posterior lobe. Sorafenib treatment was initiated. Cyclosporine treatment was continued. Three months later, abdominal enhanced CT revealed marked tumor reduction and shrinkage of the portal vein tumor thrombus. The therapeutic effect of sorafenib continued for 6 months. We did not observe deterioration in his psoriasis vulgaris and Wilson's disease for 9 months after sorafenib initiation.
要旨
症例は55歳,男性。19歳時にWilson病と診断され,D-ペニシラミンによる治療が開始となった。35歳から尋常性乾癬にてシクロスポリンの投与を受けていた。2012年,肝細胞癌(HCC)に対し肝部分切除術を施行した。2014年に腰背部痛があり,腹部造影CT検査にて肝後区域に右門脈腫瘍栓を伴う多発腫瘍を認めた。多発再発HCCと診断し,ソラフェニブによる治療を開始した。ソラフェニブ開始後も,D-ペニシラミンとシクロスポリンは継続投与した。ソラフェニブ開始3か月後と6か月後に施行した造影CT検査では,肝後区域の腫瘍と門脈腫瘍栓は著明に縮小していた。ソラフェニブ投与開始後9か月現在,尋常性乾癬とWilson病の症状は悪化なく,ソラフェニブによる治療を継続している。