{
  "abstract": "Background: Hepatic Sinusoidal Obstruction Syndrome (HSOS), formerly known as Hepatic Veno-Occlusive Disease (HVOD), is a rare and life-threatening liver condition. It is often caused by the ingestion of pyrrolizidine alkaloids (PAs), which are found in plants such as Gynura segetum (Tusanqi). Because its clinical presentation is non-specific, HSOS is frequently misdiagnosed.\n\nCase Presentation: A 72-year-old female with a 5-year history of type 2 diabetes presented with abdominal distension and anorexia for 2 weeks. Initial examinations revealed massive ascites and significantly elevated tumor markers (Cancer Antigen 125(CA125): 195.0 U/mL, Human Epididymis Protein 4(HE4): 120.1 pmol/L). Imaging suggested potential ovarian cancer, leading to diagnostic laparoscopy and bilateral adnexectomy. However, intraoperative findings and post-operative pathology showed no evidence of malignancy, identifying only a serous cystadenoma. Subsequent detailed history-taking revealed long-term ingestion of “Tusanqi.” Re-evaluation via contrast-enhanced CT and MRCP showed characteristic patterns: patchy enhancement of hepatic parenchyma (“geographic” pattern), narrow hepatic veins, and signs of portal hypertension. The patient was finally diagnosed with PA-induced HSOS. Following a regimen of anticoagulation (low-molecular-weight heparin), liver protection, and diuretics, the patient’s abdominal distension relieved, and liver function markers showed partial recovery. The patient underwent laparoscopic bilateral adnexectomy due to a high suspicion of ovarian cancer, but the postoperative pathology ruled out malignant tumors, resulting in unnecessary surgical trauma. This article aims to improve the warning effect.\n\nConclusion: This case highlights the clinical challenge of distinguishing HSOS from abdominal malignancies. A thorough dietary/herbal history and characteristic “geographic” enhancement on imaging are pivotal for avoiding unnecessary surgical interventions.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Gynecology, The first Affiliate Hospital of Henan Medical University , ,"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Ke Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Shuhua Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yijuan Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Jing Lu"
    },
    {
      "affs": [
        0
      ],
      "name": "Huiling Wang"
    },
    {
      "affs": [
        0
      ],
      "name": "Fangfang Hua"
    },
    {
      "affs": [
        0
      ],
      "name": "Jun Yang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/bk443bt7fm26x.bib",
  "cited_by": 0,
  "doi": "10.3389/fphar.2026.1833645",
  "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661801/?tool=EBI",
  "id": "bk443bt7fm26x",
  "issns": [
    "1663-9812"
  ],
  "landing_url": "https://europepmc.org/article/PMC/PMC13661801",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "1312|Plant Toxicity and Pharmacological Properties"
    ]
  ],
  "openalex": "W7214926208",
  "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661801/pdf/?tool=EBI",
  "pmcid": "PMC13661801",
  "pmid": null,
  "published": "2026-09-30",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/bk443bt7fm26x.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:17:20Z",
      "native_id": "PMC:PMC13661801",
      "source": "europepmc",
      "url": "https://europepmc.org/article/PMC/PMC13661801"
    },
    {
      "first_seen": "2026-10-30T12:20:06Z",
      "native_id": "10.3389/fphar.2026.1833645",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fphar.2026.1833645/full"
    }
  ],
  "subjects": [
    {
      "field": "biochemistry",
      "origin": "openalex:1312|Plant Toxicity and Pharmacological Properties",
      "subfield": "molecular-biology"
    }
  ],
  "title": "Case Report: Pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome misdiagnosed as ovarian malignancy",
  "title_text": "Case Report: Pyrrolizidine alkaloid-induced hepatic sinusoidal obstruction syndrome misdiagnosed as ovarian malignancy",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:06Z",
  "url": "https://research.draconitic.com/paper/bk443bt7fm26x",
  "venue": "Frontiers in pharmacology",
  "versions": []
}