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2017, Number 6

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Ann Hepatol 2017; 16 (6)

Metastases of Hepatocellular Carcinoma Misdiagnosed as Isolated Hypertrophic Cardiomyopathy

Greco A, De Masi R, Orlando S, Metrangolo A, Zecca V, Morciano G, De Donno A, Bagordo F, Piccinni G

Language: Spanish
References: 19
Page: 966-969
PDF size: 159.61 Kb.


ABSTRACT

At present, cardiac metastasis of hepatocellular carcinoma is rarely mentioned in the literature. We report a hepatocellular carcinoma patient with cardiac metastasis misdiagnosed as hypertrophic cardiomyopathy in 2011. Two years later, on presentation of syncope, an abnormal ventricular septal size was recorded by ultrasound scan, and was subsequently shown by magnetic resonance imaging to be a tumour lesion. A myocardial biopsy confirmed infiltration of hepatocellular carcinoma. This observation underlines the risk of hepatocellular carcinoma cardiac metastasis, manifested in its infiltrative form as hypertrophic cardiomyopathy. In conclusion, we suggest that the ultrasound appearance of hypertrophic cardiomyopathy in hepatocellular carcinoma patients should be seen as a “red flag” and recommend the introduction of magnetic resonance imaging assessment of transplant candidates.


REFERENCES

  1. Tinkle CL, Haas-Kogan D. Hepatocellular carcinoma: natural history, current management, and emerging tools. Biologics 2012; 6: 207-19.

  2. El-Serag HB. Hepatocellular carcinoma. N Engl J Med 2011; 365: 1118-27.

  3. A new prognostic system for hepatocellular carcinoma: a retrospective study of 435 patients: the Cancer of the Liver Italian Program (CLIP) investigators. Hepatology 1998; 28: 751-5.

  4. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61: 69-90.

  5. European Association for the Study of the Liver; European Organisation for Research and Treatment of Cancer: EASLEORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012; 56: 908-43. Erratum in: J Hepatol 2012; 56: 1430.

  6. Bruix J, Sherman M; American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma: an update. Hepatology 2011; 53: 1020-2.

  7. Khalaf N, Ying J, Mittal S, Temple S, Kanwal F, Davila J, El- Serag HB. Natural History of Untreated Hepatocellular Carcinoma in a U.S. Cohort and the Role of Cancer Surveillance. Clin Gastroenterol Hepatol 2016 Aug 10. pii: S1542- 3565(16)30517-1. doi: 10.1016/j.cgh.2016.07.033.

  8. Longo R, Mocini D, Santini M, Giannantoni P, Carillio G, Torino F, Auriti A, et al. Unusual sites of metastasis malignancy: case 1. Cardiac metastasis in Hepatocellular carcinoma. J Clin Oncol 2004; 22: 5012-14.

  9. Kan CB, Chang RY, Chen CK. Isolated right ventricular intracavitary metastasis of Hepatocellular carcinoma in a 74- year-old woman. J Chn Med Assoc 2008; 71: 318-820.

  10. Mazzaferro V, Regalia E, Doci R, Andreola S, Pulvirenti A, Bozzetti F, Montalto F, et al. Liver transplantation for the treatment of small hepatocellular carcinomas in patients with cirrhosis. N Engl J Med 1996; 334: 693-9.

  11. Martinez SM, Crespo G, Navasa M, Forns X. Noninvasive assessment of liver fibrosis. Hepatology 2011; 53: 325-35.

  12. Bosch FX, Ribes J, Diaz M, Cleries R. Primary liver cancer: worldwide incidence and trends. Gastroenterology 2004; 127: S5-S16.

  13. Yasui K, Hashimoto E, Komorizono Y, Koike K, Arii S, Imai Y, Shima T, et al. Characteristics of patients with nonalcoholic steatohepatitis who develop hepatocellular carcinoma. Clin Gastroenterol Hepatol 2011; 9: 428-33.

  14. Craxì A, Cammà C. Prevention of hepatocellular carcinoma. Clin Liver Dis 2005; 9: 329-46.

  15. Bruno S, Stroffolini T, Colombo M, Bollani S, Benvegnù L, Mazzella G, Ascione A, et al. Sustained virological response to interferon-alpha is associated with improved outcome in HCV-related cirrhosis: a retrospective study. Hepatology 2007; 45: 579-87.

  16. Chen JG, Parkin DM, Chen QG, Lu JH, Shen QJ, Zhang BC, Zhu YR, et al. Screening for liver cancer: results of a randomised controlled trial in Qidong, China. J Med Screen 2003; 10: 204-9.

  17. McMahon BJ, Bulkow L, Harpster A, Snowball M, Lanier A, Sacco F, Dunaway E, et al. Screening for hepatocellular carcinoma in Alaska natives infected with chronic hepatitis B: a 16-year population-based study. Hepatology 2000; 32: 842-6.

  18. Terasaki S, Kaneko S, Kobayashi K, Nonomura A, Nakanuma Y. Histological features predicting malignant transformation of nonmalignant hepatocellular nodules: a prospective study. Gastroenterology 1998; 115: 1216-22.

  19. Giorgio A, Di Sarno A, De Stefano G, Scognamiglio U, Farella N, Mariniello A, Esposito V, et al. Percutaneous radiofrequency ablation of hepatocellular carcinoma compared to percutaneous ethanol injection in treatment of cirrhotic patients: an Italian randomized controlled trial. Anticancer Res 2011; 31: 2291-5.




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