Noncirrhotic Portal Hypertension Associated with Oxaliplatin-based Chemotherapy for Colorectal Cancer

Abstract

Introduction: Recently, colorectal cancer history has been changing due to the use of multimodal strategies, associated with new therapeutic approaches such as metastasis resection and addressing to the primary tumor, application of radiological interventions using radioablation and embolization of liver metastases, suggestion of adjuvant and neoadjuvant chemotherapy. Among the chemotherapic new drugs is oxaliplatin, a drug that has been largely used in a protocol known as continuous infusion chemotherapy with oxaliplatin, 5-fluorouracil and folinic acid, either in adjuvant or in advanced stages of metastatic disease. Well known side effects have been described: intestinal, such as emesis and diarrhea; and neurological, such as periferic sensorial neuropathy. Case report: This article describes a patient without previous hepatic disease who, after long exposure to oxaliplatin, developed progressive trombocytopenia with a noncirrhotic splenomegaly, which are attributed to liver sinusoidal toxicity caused by prolonged use of oxaliplatin. Conclusion: This emphasizes the tendency for choosing a protocol with intermittent use of oxaliplatin to allow for the best benefits of this drug, thus reducing the risks of toxicity.