Massive bleeding from a gastric artery pseudoaneurysm in hepatocellular carcinoma treated with atezolizumab plus bevacizumab: A case report  

作　　者：Fu-Wen Pang Bin Chen De-Ti Peng Jian He Wei-Cheng Zhao Tuan-Tuan Chen Zong-Gui Xie Hai-Hui Deng 

机构地区：[1]Department of Interventional Radiology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,Guangdong Province,China [2]Department of Hepatology,Shenzhen Traditional Chinese Medicine Hospital,Shenzhen 518033,Guangdong Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2023年第6期1232-1239,共8页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND The combination of atezolizumab(ATZ)and bevacizumab(BVZ)was approved as first-line systemic therapy for advanced hepatocellular carcinoma(HCC)owing to its superior rates of response and patient survival.However,ATZ+BVZ is associated with increased risk of upper gastrointestinal(GI)bleeding,including arterial bleeding,which is rare and potentially fatal.We present a case of massive upper GI bleeding from a gastric pseudoaneurysm in a patient with advanced HCC who had been treated with ATZ+BVZ.CASE SUMMARY A 67-year-old man presented with severe upper GI bleeding after atezolizumab(ATZ)+bevacizumab(BVZ)therapy for HCC.Endoscopy failed to detect the bleeding site.Digital subtraction angiography revealed a gastric artery pseudoaneurysm and contrast extravasation from the inferior splenic artery and a branch of the left gastric artery.Successful hemostasis was achieved with embolization.CONCLUSION HCC patients who have been treated with ATZ+BVZ should be followed for 3 to 6 mo to monitor for development of massive GI bleeding.Diagnosis may require angiography.Embolization is an effective treatment.

关 键 词：Atezolizumab BEVACIZUMAB Hepatocellular carcinoma Gastric artery pseudoaneurysm Gastrointestinal bleeding Case report 

分 类 号：R735.7[医药卫生—肿瘤]