Coroner's Finding: Schuster, Gavin Shawn

45y · Male·Liver failure due to metastatic hepatocellular carcinoma

A 45-year-old male prisoner died from liver failure due to metastatic hepatocellular carcinoma. He had been prescribed cyproterone (Androcur) for 20+ years as an anti-libidinal agent, with regular blood tests monitoring liver function. Imaging from 2015-2020 showed progressive liver disease. He received appropriate specialist treatment including chemoembolisation and sorafenib, transitioning to palliative care in September 2020. The coroner found his treatment in custody appropriate and monitoring for medication side effects adequate. While liver cancer is an extremely rare side effect of cyproterone, causation could not be established. The case demonstrates appropriate clinical surveillance and management of a complex chronic condition in a custodial setting, with timely specialist involvement and appropriate end-of-life care.