Cases reported "Carcinoma, Hepatocellular"

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1/51. Case report: Hepatocellular carcinoma in type 1a glycogen storage disease with identification of a glucose-6-phosphatase gene mutation in one family.

    A 40-year-old man with glycogen storage disease type 1a (von Gierke disease, GSD1a) developed hepatocellular carcinoma (HCC). Cold single-strand conformation polymorphism (SSCP) with 12% glycerol identified the G727T mutation in the glucose-6-phosphatase (G6Pase) gene, which has been reported to be the most common mutation in Japanese GSD1a patients. This case report is the first documentation of HCC in a case with G727T mutation. Given the prevalence of HCC in GSD1a with various germline mutations, analysis is needed to confirm that the germline mutation in this case is really related to hepatocarcinogenesis. dna analysis of the family pedigree of this case, revealed three individuals with GSD1a and seven heterozygous carriers of the G727T mutation. As the diagnosis of GSD1a in this family was made only after these three patients reached adulthood, dna diagnosis may help early identification of GSD1a patients and prevention of the progression of the disease. This dna-based diagnosis permits prenatal diagnosis in at-risk patients and may facilitate screening and counselling of patients clinically suspected of having this disease.
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2/51. Manifestations of hypercholesterolaemia, hypoglycaemia, erythrocytosis and hypercalcaemia in patients with hepatocellular carcinoma: report of two cases.

    BACKGROUND: Hypercholesterolaemia, hypoglycaemia, hypercalcaemia and erythrocytosis, are well-known paraneoplastic manifestations in patients with hepatocellular carcinoma (HCC). Hepatocellular carcinoma patients manifesting with two or three paraneoplastic manifestations have been previously reported. However, HCC patients presenting with four paraneoplastic syndromes have not been previously reported. methods AND RESULTS: This manuscript describes two HCC patients who manifested with hypercholesterolaemia, hypoglycaemia, hypercalcaemia and erythrocytosis during their clinical course. Erythrocytosis appeared early when HCC was diagnosed and declined to within normal range after optimal therapy for HCC. Hypercholesterolaemia manifested initially after the diagnosis in case 1, declined to within normal range after lobectomy and was re-elevated after tumour recurred. With disease progression, hypercalcaemia and hypoglycaemia occurred 1-3 months after diagnosis and the both patients subsequently died several days later. CONCLUSIONS: Similar features found in both patients were large tumour burden, high serum alpha-fetoprotein level and rapid downhill clinical course even with optimal therapy. The clinical significance of these paraneoplastic manifestations is discussed.
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ranking = 15.773952372881
keywords = disease progression, progression
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3/51. Generalized intraperitoneal seeding of hepatocellular carcinoma after microwave coagulation therapy: a case report.

    We first describe a case of generalized intraperitoneal seeding of hepatocellular carcinoma (HCC) after microwave coagulation therapy (MCT). A 61 year-old man underwent operative MCT for an exophytic HCC, 60 mm in diameter, in segment IV of his cirrhotic liver. Despite successful tumor ablation, the serum alpha-fetoprotein levels continuously rose after MCT. Five months later, radiographic examinations delineated several perihepatic masses with hypervascularity, and the patient presented with constipation. At the second laparotomy, there were numerous small peritoneal metastases involving the entire peritoneal cavity and slightly bloody ascites. An omental mass, 50 mm in diameter, involved the transverse colon. Most of these intraabdominal masses were removed together with the involved colon. Histologically, the initial tumor was a moderately differentiated HCC, and the peritoneal masses were poorly differentiated HCCs. The patient died of rapid tumor progression and bleeding 2 months later. In conclusion, we should be aware of the possible occurrence of peritoneal seeding after MCT for HCC. Every effort should be made to prevent this serious complication, particularly in cases of superficial, large, and less differentiated HCCs.
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4/51. A case with intrahepatic double cancer: hepatocellular carcinoma and cholangiocarcinoma associated with multiple von Meyenburg complexes.

    Combined hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) is sometimes found in resected livers, however, cases with double cancer of HCC and CC are very rare. As well, the rarity of CC arising in von Meyenburg complexes (VMCs) is appreciated. We report the case of a 74-year-old man found to have intrahepatic double cancer composed of well-differentiated HCC and CC which exhibited a histologic progression from VMCs to adenomatous lesions and CC. To our knowledge, this is the first case report published in the literature of a double HCC and CC associated with multiple VMCs. The pathogenesis and previous associated reports of these lesions are discussed.
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5/51. The natural history of hepatitis c viral infection.

    Although early data suggested that chronic hepatitis c virus infection carried little risk, studies with longer duration of infection have reported concerning results. Of patients with acute infection, approximately 80% will develop chronic infection. The greatest risk of morbidity comes with cirrhosis and the resulting increased risk of hepatocellular carcinoma. The true risk of progression to cirrhosis, however, has emerged as an area of controversy. Both host and viral factors seem to impact susceptibility to chronic infection, cirrhosis, and hepatocellular carcinoma. hepatitis c virus has become the most common indication for liver transplantation, but the infection routinely recurs and may have a more aggressive course after transplantation. Given that current treatment options for hepatitis c virus infection are clearly not optimal, informed decisions regarding treatment require an in depth understanding of the natural history.
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6/51. Hepatocellular carcinoma presenting as portal thrombosis with intrabiliary growth: US and MR findings.

    We present an unusual case of hepatocellular carcinoma presenting as massive portal vein thrombosis with progression to the intrahepatic bile ducts without demonstrable primary hepatic tumor. Ultrasound, magnetic resonance, and percutaneous transhepatic cholangiography findings are described. The histologic diagnosis was achieved by means of percutaneous forceps biopsy of the endobiliary mass.
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7/51. Complete remission of unresectable hepatocellular carcinoma on healthy liver by the combination of aggressive surgery and high-dose-intensity chemotherapy by CPT-11.

    Hepatocellular carcinoma (HCC) is one of the most frequent cancers. The only curative treatment is liver transplantation or complete surgical resection; however, most patients have inoperable disease at diagnosis. To date, no cytotoxic agent has demonstrated a clinical impact on time-related parameters, especially survival. The development of new treatments of inoperable HCC patients is highly desirable. Among the new cytotoxic agents, dna topoisomerase I poisons are those with the widest spectrum of antitumor activity. However, few data are available in HCC patients. One of the main obstacles to the use of irinotecan in HCC is the frequent alterations of liver function at diagnosis. A 48-year-old patient with a HCC that had developed within a normal liver but of very poor prognosis because of a multifocal primary tumor with a large nodule measuring 10 cm of diameter, associated with a portal thrombosis, could tolerate very intensive treatment with irinotecan using doses up to 700 mg/m2 every 2 weeks and was responsive to treatment as measured by alpha-fetoprotein levels. Despite initial criteria of inoperability, the absence of disease progression under therapy with a follow-up of 1 year invited us to propose a liver transplant. The patient is still in post-surgical complete remission and has consolidation chemotherapy with irinotecan. This result invites us to consider the evaluation of the efficacy of topoisomerase I poisons in HCC patients and to escalate the dose of irinotecan in patients with less than grade 4 neutropenia.
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ranking = 15.773952372881
keywords = disease progression, progression
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8/51. Rapid progression of hepatocellular carcinoma after transcatheter arterial chemoembolization and percutaneous radiofrequency ablation in the primary tumour region.

    We report one patient who showed rapid progression of hepatocellular carcinoma (HCC) after undergoing transcatheter arterial chemoembolization (TACE) and percutaneous radiofrequency ablation (PRFA) for a small HCC measuring 2.5 cm in diameter. Enhanced magnetic resonance imaging (MRI) following treatment showed complete tumour necrosis and did not reveal the presence of a tumour around the treated area. Furthermore, the serum alpha-fetoprotein (AFP) level decreased at the completion of therapy. However, the HCC advanced in a very short time. Numerous tumours around the treated area were observed on enhanced computed tomography (CT) 50 days after PRFA. It is strongly suspected that the tumour was disseminated through the portal system because of the presence pattern of tumours. We believe this to be the first case illustrating a hepatic cancer that progressed rapidly following TACE and PRFA.
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keywords = progression
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9/51. Increased expression of transforming growth factor-alpha in a patient with recurrent hepatocellular carcinoma following partial hepatectomy.

    A 45-year-old woman with chronic hepatitis b underwent partial hepatectomy for hepatocellular carcinoma (HCC). However, the HCC recurred 2 months after surgery and rapid progression of the disease resulted in her death. immunohistochemistry showed that transforming growth factor-alpha (TGFalpha) was barely expressed in the liver specimens obtained at hepatic resection, whereas autopsy specimens were strongly stained with anti-TGFalpha antibody in the cytoplasm of both non-tumourous and tumourous liver cells. A higher level of Ki67 expression, a proliferating marker, was observed in the recurrent HCC, similar to that of TGFalpha. Thus, we speculate that the partial hepatectomy increased the level of TGFalpha leading to recurrence and progression of HCC through an autocrine/paracrine mechanism.
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keywords = progression
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10/51. Living related liver transplantation for recurrent hepatocellular carcinoma in a normal liver.

    The role of liver transplantation for hepatocellular carcinoma (HCC) is evolving. In patients with advanced liver disease and early stage HCC, transplantation offers the best hope for cure. A living donor offers the optimal approach to a timely transplant, before disease progression obviates the potential benefit. But extending the indications beyond those designated by the United Network for Organ Sharing (UNOS) for liver transplantation for HCC is controversial [Hepatology 2001: 33: 1073; Liver Transplant 2000: 6: S1]. cadaver split techniques and use of living donors are potentially compelling ways to test the limitations of liver transplantation for HCC, without notably reducing the cadaver organ pool. Herein, we report a rare case of a patient who developed a well-differentiated HCC in a normal liver. After resection of the index lesion and, later, of a remote recurrent lesion, a living donor liver transplant was offered. The natural history of this lesion and the management of transplantation in this setting are discussed.
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ranking = 15.773952372881
keywords = disease progression, progression
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