Hepatic tumor rupture following effectual treatment with irinotecan in a patient with highly refractory malignant lymphoma

We describe a patient with highly refractory malignant lymphoma who died of hepatic tumor rupture following treatment with irinotecan (CPT-11). This 6 0-year-old man with non-Hodgkin's lymphoma (diffuse large B-cell lymphoma) demonstrated disease recurrence in the liver and the vertebrae following hi gh-dose chemotherapy and autologous hematopoietic stem cell transfusion. He was treated with CPT-11 at a dose of one third of the conventional dose us ed fur non-Hodgkin's lymphoma in Japan. The tumor in the liver markedly dec reased in size but then ruptured. Although pathologic hepatic tumor rupture is a rare complication in patients with malignant lymphoma of the liver, t his case demonstrates that hepatic tumor rupture may occur in refractory ma lignant lymphomas that reveal extensive degradation by this new, effective salvage therapy. (C) 1999 The Japanese Society of Hematology.