Detection of hepatitis C virus replication in ovarian metastases of a patient with hepatocellular carcinoma

Hepatocellular carcinoma is one of the most common human cancers with an annual incidence of about 1,000,000 cases worldwide. Although hepatocellular carcinoma is predominant in hepatitis B virus endemic areas, it has also become a major problem in Europe, Japan and North America in close association with the increasing incidence of hepatitis C virus infection. The pathogenetic role of hepatitis C virus infection in the development of HBsAg-negative hepatocellular carcinoma needs to be clarified. In this paper the case of a 66-year-old HBsAg-negative and anti-HCV positive female who developed hepatocellular carcinoma in a cirrhotic liver is reported. After 1 year of follow up, urgent laparotomy had to be performed due to highly differentiated ovarian metastases of the hepatocellular carcinoma. Plus- and minus-stranded HCV-RNA was detected by reverse transcription and "nested" polymerase chain reaction in both the patient's serum and in the metastatic ovarian tissue.