Substernal Mass: A Rare Presentation of Hepatocellular Carcinoma
Journal Title: Oman Medical Journal - Year 2019, Vol 34, Issue 6
Abstract
A 62-year-old female with a history of hepatitis C presented with one week of worsening abdominal distension. On physical examination, she had icterus, abdominal distension, shifting dullness, and a positive fluid wave. Computed tomography (CT) of the abdomen and pelvis demonstrated a small left hepatic lobe lesion and moderate ascites. Chest CT demonstrated a large substernal mass (3.5 × 1.7 cm) in the anterior mediastinal fat in the region of prepericardial lymph nodes. Following resection of the substernal mass, histopathology revealed metastatic involvement by poorly differentiated hepatocellular carcinoma (HCC). The patient was in fulminant liver failure postoperatively and succumbed to her disease. Mediastinal lymph nodes metastases in HCC are rare and often portend a poor prognosis when present. We discuss a case of HCC presenting with a substernal mass, and provide a literature review of the management and prognosis of lymphatic spread of HCC.
Authors and Affiliations
Kevin Yuqi Wang, Mohammad Ghasemi Rad, Camelia Arsene, Doina David
Keywords
Related Articles
- EP ID EP671288
- DOI 10.5001/omj.2019.101
- Views 86
- Downloads 0
Diabesity in the Arabian Gulf: Challenges and Opportunities
Diabesity (diabetes associated with obesity) is a major global and local public health concern, which has almost reached an epidemic order of magnitude in the countries of the Arabian Gulf and worldwide. We sought to rev...
Impact of Implementing Grading Fine Needle Aspiration Cytology in Diagnosis of Breast Cancer amongst Sudanese Women
Objectives: This study estimated the merit of employment of Grading Fine Needle Aspiration Cytology (GFNAC) in the assessment of breast lumps, compared to conventional Conventional Fine Needle Aspiration Cytology (CFNAC)...
Epidemiological and Clinical Features of Salmonella Typhi Infection Among Adult Patients in Qatar: A Hospital-based Study
Objectives: We sought to describe the epidemiological and clinical features of typhoid fever in Qatar. Methods: We conducted a retrospective study of adult patients treated for typhoid fever at Hamad General Hospital and...
Occurrence of Hypothyroidism, Diabetes Mellitus, and Celiac Disease in Emirati Children with Down’s Syndrome
Objectives: Autoimmune diseases are known to occur in people with Down’s syndrome (DS), especially celiac disease, type 1 diabetes mellitus (DM), and hypothyroidism. Since there are common genetic risk factors involved i...
The Efficacy of Zinc Administration in the Treatment of Primary Dysmenorrhea
Objectives: Dysmenorrhea is a common complaint in women. Primary dysmenorrhea is defined as painful menstruation in the absence of pelvic disease and is caused by uterine contractions caused by prostaglandins released fr...