Metastatic hepatocellular carcinoma to the pelvis and vertebrae in a patient with chronic hepatitis 'C' with unknown primary.
Metastatic hepatocellular carcinoma to the pelvis and vertebrae in a patient with chronic hepatitis 'C' with unknown primary.
复制标题
DOI：
10.1136/bcr-2014-207249
复制
发表时间：
2015-02-20
期刊：
影响因子：
0.9
通讯作者：
Hussain, Syed Jawad Akhtar
中科院分区：
文献类型：
--
作者：
Abbas, Syed Hussain;Khan, Muhammad Zia Ul Islam;Hussain, Syed Jawad Akhtar
一名54岁男性感染丙型肝炎病毒向我们就诊，过去2个月右髂窝放射至背部和右大腿疼痛。腹部及骨盆影像学显示一软组织肿块附着于右髂叶及骶骨右翼。行组织活检，免疫组化Glypican-3和Hep-par - 1进行组织病理学分析，诊断肿块为肝细胞癌。这是一个独特的肝细胞癌骨转移的病例，肝脏影像学未显示任何原发性病变。肝功能检查显示，天冬氨酸转氨酶和丙氨酸转氨酶是正常范围的两倍，病毒载量高，血清甲胎蛋白明显升高。患者接受5-氟尿嘧啶静脉注射和放疗作为姑息性措施，临床改善不明显。
A 54-year-old man infected with hepatitis C virus presented to us with pain in the right iliac fossa radiating to the back and right thigh for the past 2 months. Imaging of the abdomen and pelvis was performed, which revealed a soft tissue mass adherent to right iliac blade and right ala of sacrum. Trucut biopsy of the mass was performed and immunohistochemical stains Glypican-3 and Hep-par 1 were used for histopathological analysis, which diagnosed the mass as hepatocellular carcinoma. This is a unique case of metastasis of hepatocellular carcinoma to the bone in which imaging of the liver did not show any primary lesion. Liver function tests showed that aspartate transaminase and alanine transaminase were twice the normal range with a high viral load and significantly raised serum alpha-fetoprotein. The patient was treated with intravenous 5-flourouracil and radiotherapy as a palliative measure with only moderate clinical improvement.