Chemotherapy-related persistent indirect hyperbilirubinemia.

In spite of the improvement on chemotherapy results in treating testicular cancer and the introduction of adjuvant chemotherapy to node negative (as well as node positive) breast cancer patients, there is still present a wide spectrum of early and late toxic manifestations. The combination of cisplatin, vinblastine and bleomycin given to testicular cancer might result in cariovascular, neurological, gastrointestinal and renal problems. Late effects of cyclophosphamide, methotrexate and 5-fluorouracil given to breast cancer patients might cause obesity, amenorrhea and infertility. We report a persistent asymptomatic indirect hyperbilirubinemia which was observed in two cancer patients (breast; testis) 3 and 14 months following the cessation of chemotherapy. Metastatic liver disease and involvement of other sites, as well as other causes of hyperbilirubinemia, were excluded. The exact cause of the indirect hyperbilirubinemia remained obscure.