Successful Treatment in a Case of Massive Hepatocellular Carcinoma with Paraneoplastic Syndrome.

Case Reports in Gastroenterology
Atsunori TsuchiyaYutaka Aoyagi

Abstract

Paraneoplastic syndromes of hepatocellular carcinoma (HCC) are not uncommon. However, the prognosis is poor and follow-up and improvement of paraneoplastic syndromes with treatment have been reported rarely. We report a successful case in an aged man of a massive HCC with paraneoplastic syndrome, treated by combined intraarterial chemotherapy and hepatic resection. Paraneoplastic syndrome (erythrocytosis and hyperlipidemia) was monitored throughout the treatment and erythropoietin (EPO) mRNA also was analyzed in the resected liver. The hemoglobin level and serum levels of EPO and total cholesterol (T-cho) decreased dramatically with treatment, along with a decrease in serum levels of alpha-fetoprotein and protein induced by vitamin vitamin K absence II (PIVKA-II). Semiquantitative reverse transcription polymerase chain reaction (RT-PCR) revealed that the residual cancer expressed EPO RNA but the nontumor tissue did not. This was a rare case of paraneoplastic syndrome of HCC that was treated successfully. This case indicates that paraneoplastic syndrome reflected tumor progression and that serum levels of both EPO and T-cho might be used as tumor markers.

Citations

Jul 24, 2013·Archives of Toxicology·Sabrina EhnertAndreas K Nussler
Nov 26, 2013·Journal of Vascular and Interventional Radiology : JVIR·Maureen WhitsettJonathan M Fenkel
Oct 25, 2016·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Shizhong KeHongyang Wang
Dec 21, 2017·Inflammation and Regeneration·Atsunori TsuchiyaShuji Terai
Mar 13, 2021·Hepatology : Official Journal of the American Association for the Study of Liver Diseases·Arani SathiyapalanBrandon M Meyers

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