Hepatic failure induced by cyproterone acetate: A case report and literature review.

Cyproterone acetate (CPA) is an anti-androgenic drug that has been used to manage prostate cancer. The drug is well-tolerated, but has hepatotoxic effects. Hepatic failure induced by CPA is rare urologists tend to overlook its severity. We report a patient with metastatic prostate cancer who developed CPA-induced hepatic failure that manifested as bilirubinuria, which was initially misinterpreted as gross hematuria. The patient died despite receiving critical care. The aim of this study is to sound the alarm about CPA-induced hepatic failure.