Hepatoma in a child with methotrexate-induced hepatic fibrosis
F. B. Ruymann, A. D. Mosijczuk and R. J. Sayers
During autopsy, an 11-year-old girl with acute lymphocytic leukemia was
found to have hepatic fibrosis with a 2.5-cm nodule of hepatocarcinoma. For
5 1/2 of the six years of treatment, chemotherapy consisted of daily orally
administered methotrexate with monthly doses of vincristine sulfate and
prednisone. The cumulative dose of methotrexate was 2.5 g. To our
knowledge, this report constitutes the first association of hepatoma with
methotrexate-induced hepatic fibrosis. A careful follow-up of patients
receiving methotrexate for malignant neoplasms is urged; caution is
suggested in the prolonged use of methotrexate when treating benign
disease.
