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KMID : 0939920210530010283
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대한암학회지
2021 Volume.53 No. 1 p.283 ~ p.288
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Hyperammonemic Encephalopathy Mimicking Ornithine Transcarbamylase Deficiency in Fibrolamellar Hepatocellular Carcinoma: Successful Treatment with Continuous Venovenous Hemofiltration and Ammonia Scavengers
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Lee Jeong-Seon
Jin Hye-Young
Ko Jung-Min
Kim Seoung-Hoon
Han Na-Young
Park Byung-Kiu
Park Mee-Rim
Park Hyeon-Jin
Lee Jun-Ah
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Abstract
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Fibrolamellar hepatocellular carcinoma (FLHCC) is a rare liver cancer affecting adolescents and young adults without any pre existing liver disease. Hyperammonemic encephalopathy (HAE) is a serious paraneoplastic syndrome, and several cases of HAE have been reported in patients with FLHCC. This condition is rare; hence, there are currently no management guidelines for cancer-related HAE. Herein, we report a case of an 18-year-old man with advanced FLHCC who developed HAE during the first course of chemotherapy consisting of cisplatin, doxorubicin, 5-fluorouracil, and interferon-α. He was successfully treated with continuous venovenous hemofiltration, sodium benzoate, sodium phenylbutyrate, and amino acid supplementation for HAE. After the second course of chemotherapy, he underwent surgery, and thereafter, his ammonia levels were normal without any ammonia scavenger therapy. Treatments for HAE described here will be helpful for this rare, but serious metabolic complication of FLHCC and could partially applied to HAE related to any malignancies.
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KEYWORD
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Fibrolamellar hepatocellular carcinoma, Hyperammonemia, Encephalopathy, OTC deficiency
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