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<p>This case report describes a 77-year-old man with chronic hepatitis C-related hepatocellular carcinoma who developed severe portal vein thrombosis after combination therapy with atezolizumab (ATZ) plus bevacizumab (BEV). Following treatment, he experienced abdominal distension and subsequent deterioration, leading to hospitalization. Despite intensive care, including anticoagulation therapy, the patient succumbed to multi-organ failure. An autopsy revealed intestinal necrosis, along with severe thrombosis of the portal vein and superior mesenteric vein. This case highlights a rare but serious risk of portal vein thrombosis associated with ATZ plus BEV therapy, underscoring the need for vigilant monitoring in patients receiving this treatment.</p>

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Fatal portal vein thrombosis following combination therapy with atezolizumab plus bevacizumab for hepatocellular carcinoma: an autopsy case report

  • 期刊论文

  • 发表日期：

    2025年8月1日

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  • Yutaro Mihara,
  • Yu Noda,
  • Kotaro Iemura,
  • Miwa Sakai,
  • Hideki Iwamoto,
  • Reiichiro Kondo,
  • Takashi Niizeki,
  • Hironori Kusano,
  • Takumi Kawaguchi,
  • Jun Akiba

摘要

This case report describes a 77-year-old man with chronic hepatitis C-related hepatocellular carcinoma who developed severe portal vein thrombosis after combination therapy with atezolizumab (ATZ) plus bevacizumab (BEV). Following treatment, he experienced abdominal distension and subsequent deterioration, leading to hospitalization. Despite intensive care, including anticoagulation therapy, the patient succumbed to multi-organ failure. An autopsy revealed intestinal necrosis, along with severe thrombosis of the portal vein and superior mesenteric vein. This case highlights a rare but serious risk of portal vein thrombosis associated with ATZ plus BEV therapy, underscoring the need for vigilant monitoring in patients receiving this treatment.