1. Hepatocellular Carcinoma in a Patient with Hereditary Hemorrhagic Telangiectasia
- Author
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Shiso Sato, Hiroaki Okushin, Shinichiro Nakamura, Riku Uematsu, Kyohei Kai, Takeharu Yamamoto, Takanori Watanabe, Noriyuki Nishiwaki, and Kazuhiko Morii
- Subjects
0301 basic medicine ,Pathology ,medicine.medical_specialty ,Cirrhosis ,Carcinoma, Hepatocellular ,medicine.medical_treatment ,Population ,Ischemia ,Case Report ,Endoscopy, Gastrointestinal ,vascular malformation ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Fatal Outcome ,Internal Medicine ,medicine ,hereditary hemorrhagic telangiectasia ,Humans ,education ,Telangiectasia ,Pathological ,ischemic liver cirrhosis theory ,Aged ,focal nodular hyperplasia ,education.field_of_study ,business.industry ,Liver Neoplasms ,Focal nodular hyperplasia ,General Medicine ,hepatocellular carcinoma ,medicine.disease ,Magnetic Resonance Imaging ,030104 developmental biology ,030220 oncology & carcinogenesis ,Hepatocellular carcinoma ,Female ,Telangiectasia, Hereditary Hemorrhagic ,Hepatectomy ,medicine.symptom ,business ,Tomography, X-Ray Computed - Abstract
A 76-year-old woman with hereditary hemorrhagic telangiectasia (HHT) showed elevated serum hepatobiliary enzyme levels, and abdominal imaging studies revealed a hepatic tumor. Her serum alpha-fetoprotein level was 759.5 ng/mL. A pathological examination after hepatectomy confirmed a diagnosis of hepatocellular carcinoma (HCC). An examination of the surrounding liver revealed dilated vessels and thickened endothelial cells without inflammations. HHT patients without other risk factors (like this patient) reportedly have a lower incidence of common cancers, including HCC, in comparison to the unaffected population. One intriguing hypothesis that might explain the hepatocarcinogenesis in this situation is the ischemic liver cirrhosis theory, which suggests that chronic ischemia may cause parenchymal strain and promote inappropriate hepatocyte proliferation.
- Published
- 2018