Portal venous tumor growth-type of hepatocellular carcinoma without liver parenchyma tumor nodules: a case report
Journal Title: Annals of Hepatology - Year 2013, Vol 12, Issue 6
Abstract
The patient was a 43-year-old man with chronic hepatitis B without history of hepatocellular carcinoma (HCC), who was first diagnosed with thrombosis in right portal vein trunk and portal vein branches and ruptured esophageal varices in October 2011. He underwent endoscopic variceal ligation, but ruptured repeatedly. Despite anti-coagulant therapy, the thrombosis expanded from right portal vein trunk to upper mesenteric vein in March 2012. Computed tomography (CT) scan showed that portal vein thrombosis had low density from early to late phase. No focal liver lesions were identified by CT scan or ultrasound, and alpha-fetoprotein (AFP) was within normal range. He died by intractable esophageal variceal bleeding in April 2012. Pathological examination of autopsy specimen showed that portal vein thrombosis was consistent with poorly-differentiated HCC. The portal vein tumor thrombosis (PVTT) had only a few tumor vessels, which were compressed by fibromatous change originating from HCC formation, so were represented as low-density lesions from arterial to portal phase of CT. In addition, PVTT was negative for AFP, so representing serum value of AFP within normal range. PVTT had positive staining for c-kit, which is a liver stem cell marker. Liver tumors in the whole liver parenchyma were not found pathologically. PVTT might have the characteristics of presumed liver cancer stem cells. We experienced the first case of HCC only in portal vein without liver parenchyma tumor nodules, with difficult differential diagnosis from a non-malignant portal vein thrombosis. We also reported new tumor profiles of the portal venous tumor growth- type of HCC.
Authors and Affiliations
Masaya Saito, Yasushi Seo, Yoshihiko Yano, Keiichiro Uehara, Shigeo Hara, Kenji Momose, Hirotaka Hirano, Hiroshi Yokozaki, Masaru Yoshida, Takeshi Azuma
Keywords
Related Articles
- EP ID EP78347
- DOI -
- Views 128
- Downloads 0
Hepatic encephalopathy, ammonia, glutamate, glutamine and oxidative stress
This review addresses recent and not so recent works that emphasize on the mechanisms by which liver damage can induce encephalopathy. Hepatic encephalopathy constitutes an intriguing complication in severe liver acute a...
Diagnostic accuracy of magnetic resonance elastography in liver transplant recipients: A pooled analysis
Background and aims. We conducted an individual participant data (IPD) pooled analysis on the diagnostic accuracy of magnetic resonance elastography (MRE) to detect fibrosis stage in liver transplant recipients. Materia...
Hepatitis C Virus Infection and Risk of Venous Thromboembolism: A Systematic Review and Meta-Analysis
Background/Objectives. Hepatitis C virus (HCV) infection is one of the leading causes of cirrhosis. As a result of chronic inflammatory response to the virus, HCV-infected patients may be at a higher risk of venous throm...
Hepatic Echinococcosis with Thoracic Involvement. Clinical Characteristics of a Prospective Series of Cases
Abstract Introduction. Thoracic involvement (TIHE) is one of the evolutionary complications of hepatic echinococcosis (HE). Aim. The aim of this study was to describe the clinical characteristics and postoperative morbid...
Alcohol Consumption Influences Clinical Outcome in Patients Admitted to a Referral Center for Liver Disease
Introduction and aim. Excessive alcohol consumption is a public health concern worldwide and has been associated with high mortality rates. This study aimed to determine the prevalence of alcohol consumption and its infl...