Hepatic sinusoidal obstruction syndrome secondary to intravesical instillation of mitomycin-C

  • Álvaro Marchán-López
  • María Asunción Pérez-Jacoiste AsínEmail author
  • Justino Jiménez-Almonacid
  • Marta Arroyo-López
  • Juan Justo-Quintas
Case Report


Hepatic sinusoidal obstruction syndrome (SOS) is a life-threatening complication with high mortality rate. Even if it is more commonly described after hematopoietic stem-cell transplant, hepatic-SOS may occur following the use of certain chemotherapeutic agents. Mitomycin-C has been previously identified as a causal agent when administered intravenously at high doses. We report herein the first case of hepatic-SOS due to intravesical instillation of mitomycin-C, after a traumatic urinary catheterization with significant hematuria. Although this procedure is usually considered safe, without the systemic side effects related to intravenous administration of the drug, clinicians must be aware of its potential risks to facilitate an early diagnosis, avoid a delay in the withdrawal of the causative drug and set up an appropriate therapy as soon as possible.


Intravesical instillation Mitomycin-C Bone marrow aplasia Hepatic sinusoidal obstruction syndrome 



Sinusoidal obstruction syndrome


Granulocyte-colony-stimulating factor


Author contributions

All the authors made substantial contributions to the conception and design of the work. Marchán-López and Pérez-Jacoiste Asín wrote the manuscript; Pérez-Jacoiste Asín and Justo-Quintas critically reviewed the manuscript; Jiménez-Almonacid provided the histological diagnosis; Arroyo-López performed and provided data of the transjugular hepatic-vein catheterization; Marchán-López and Pérez-Jacoiste Asín were in charge of medical care of the patient. All the authors approved the final draft of the manuscript to be published. All the authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy and integrity of any part of the work are appropriately investigated and resolved.


No funding sources.

Compliance with ethical standards

Conflict of interest

The authors declare no conflict of interest.

Human/animal Rights

All the procedures have been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendements.

Informed consent

The family of the patient gave informed consent for the publication of the case. Confidentiality was preserved.


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Copyright information

© Japanese Society of Gastroenterology 2019

Authors and Affiliations

  • Álvaro Marchán-López
    • 1
  • María Asunción Pérez-Jacoiste Asín
    • 1
    Email author
  • Justino Jiménez-Almonacid
    • 2
  • Marta Arroyo-López
    • 3
  • Juan Justo-Quintas
    • 4
  1. 1.Department of Internal MedicineHospital Universitario 12 de Octubre, Instituto de Investigacion Hospital 12 de Octubre (i+12), Universidad ComplutenseMadridSpain
  2. 2.Department of PathologyHospital Universitario 12 de OctubreMadridSpain
  3. 3.Department of Vascular RadiologyHospital Universitario 12 de OctubreMadridSpain
  4. 4.Department of UrologyHospital Universitario 12 de OctubreMadridSpain

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