Chronic active hepatitis induced by pazopanib mimicking hypervascular liver metastases in a patient with recurrent soft tissue sarcoma: A case report

Abstract

Pazopanib is the first multitargeted tyrosine kinase inhibitor approved for the treatment of patients with advanced non adipocytic soft tissue sarcoma (STS). It has been demonstrated to improve progression free survival without impairing health associated quality of life. However, Pazopanib is associated with several adverse side effects associated with inhibition of the vascular endothelial growth factor receptor. These include hepatotoxicity, as manifested by abnormal liver function tests. To the best of our knowledge, the current study presents the first case of a patient with recurrent STS who developed biopsy proven Pazopanib induced chronic active hepatitis and whose previous computed tomography examination demonstrated multiple hypervascular liver lesions. These lesions were indistinguishable from metastases and to the best of our knowledge, have not been described previously. These lesions therefore appear to be a novel finding of Pazopanib induced chronic active hepatitis. It is crucial to be aware of this unusual finding within a clinical setting, to avoid overstaging and early discontinuation of effective treatment.