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December 28, 1984

Hepatic Angiosarcoma and Bronchioloalveolar Carcinoma Induced by Fowler's Solution

Author Affiliations

From the Section of Hematology (Dr Kasper) and Department of Internal Medicine (Drs Kasper and Theologides), University of Minnesota; and the Department of Pathology (Drs Schoenfield and Strom) and Section of Hematology/Oncology (Dr Theologides), Hennepin County Medical Center; Minneapolis.

JAMA. 1984;252(24):3407-3408. doi:10.1001/jama.1984.03350240053040

THE MEDICINAL use of Fowler's solution reached its heyday during the Victorian age, but arsenical solutions continued to be prescribed for dermatological conditions until the 1960.1 Following intake of arsenic, in the patient we describe, a hepatic angiosarcoma and a bronchioloalveolar carcinoma appeared simultaneously after a prolonged latent period.

Report of a Case  A 67-year-old man had been well until seven months before his death. At that time he was found to have ascites, abnormal liver function test results, and decreased hepatic uptake with multiple focal defects appearing on a liver-spleen isotope scan. Tests for carcinoembryonic antigen and α-fetoprotein gave negative results, and the results of a liver biopsy were not diagnostic.On referral to our hospital, he was cachectic, with scleral icterus, asterixis, fetor hepaticus, and rales in the base of the right lung. He had ascites without abdominal organomegaly or masses. His palms and soles had hyperkeratotic