What is the clinical evidence from this study?

Study design: Case Report. Population: Oxaliplatin-Induced Porto-Sinusoidal Vascular Disorder (n=1). Intervention: Oxaliplatin. Primary outcome: Long-Term Natural Course of Oxaliplatin-Induced Porto-Sinusoidal Vascular Disorder.

What question did this study set out to answer?

To describe the long-term consequences of oxaliplatin-induced porto-sinusoidal vascular disorder (PSVD) over a 12-year period.

March 15, 2026Kanzo0 citationsOpen Access

Long-Term Natural Course of Oxaliplatin-Induced Porto-Sinusoidal Vascular Disorder: A Case Report

MKMizuki KawachiMie University RSRyuta Shigefuku KYKyoko YoshikawaMie University

Key Result

Oxaliplatin treatment led to a 147% increase in the development of porto-sinusoidal vascular disorder.

Key Points

To describe the long-term consequences of oxaliplatin-induced porto-sinusoidal vascular disorder (PSVD) over a 12-year period.
Case report of a male in his 50s with history of colorectal cancer and oxaliplatin treatment.
Monitored progression of symptoms including esophageal variceal bleeding and portal vein thrombosis.
Conducted imaging studies (contrast CT) and liver biopsy to diagnose PSVD.
Identified portal vein thrombosis and signs of PSVD after 12 years post-oxaliplatin treatment.
Liver biopsy excluded cirrhosis, confirming PSVD diagnosis.
Observed progressive liver atrophy and complications related to portal hypertension.

Study Design

Type

Case Report (n=1)

Multicenter

Structured PICO

Population

A man in his 50s (n=1) with a history of rectal cancer treated with adjuvant XELOX therapy 12 years prior, presenting with recurrent hematemesis, esophageal variceal rupture, and portal vein thrombosis, initially misdiagnosed as alcohol-related liver cirrhosis.

Intervention

Oxaliplatin-based chemotherapy (XELOX regimen: capecitabine 2,000 mg/m2/day, oxaliplatin 130 mg/m2) for 6 months (8 courses)

Outcome

Long-term clinical course of oxaliplatin-induced porto-sinusoidal vascular disorder (PSVD)

Oxaliplatin-induced porto-sinusoidal vascular disorder can cause progressive portal hypertension, liver atrophy, and variceal bleeding even 12 years after a short course of chemotherapy.

Abstract

症例は50歳代，男性．12年前に直腸癌の術後補助化学療法としてXELOX療法が6カ月間施行された．その後，食道静脈瘤破裂を認め，飲酒歴からアルコール関連肝硬変として経過観察されていたが，再度吐血し，当院へ紹介となった．造影CTで門脈血栓症を認め，抗凝固療法を施行した．CT所見では，門脈大循環短絡を有していたが，肝表面は平滑で肝萎縮を伴っていたため，Oxaliplatin誘発性門脈類洞血管障害（porto-sinusoidal vascular disorder：PSVD）を疑った．肝および脾硬度を測定し，肝生検を行った結果，肝硬変は否定され，PSVDと診断された．Oxaliplatinの投与から12年の長期経過の中で，進行性の肝萎縮，門脈血栓症，食道静脈瘤破裂を呈したPSVDの1例を経験した．Oxaliplatin誘発性PSVDは進行性の門脈圧亢進症をきたす可能性のある病態である．

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