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Extra-hepatic hepatocellular carcinoma presenting as obstructive jaundice
J A Batsis1, T R Halfdanarson, H Pitot
1Department of Medicine, Mayo School of Graduate Medical Education, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA. batsis.john@mayo.edu
Summary
Hepatocellular carcinoma (HCC) is a liver cancer with poor prognosis. This case highlights atypical presentations of HCC, emphasizing the need for vigilant diagnosis even without typical risk factors.
Area of Science:
- Hepatology
- Oncology
- Pathology
Background:
- Hepatocellular carcinoma (HCC) is a common primary liver cancer with a poor prognosis.
- Risk factors include chronic hepatitis B/C, hemochromatosis, and alpha-1-antitrypsin deficiency, predisposing individuals with chronic liver disease.
- Incidence is higher in Asia and Africa, but increasing in the US.
Observation:
- Presents a case of HCC with atypical clinical features.
- The patient lacked typical predisposing risk factors for HCC.
- No primary liver lesion causing obstructive jaundice was initially identified.
Findings:
- Diagnosis of HCC was established after obtaining multiple tissue specimens.
- Atypical presentation complicated the initial diagnostic process.
- Pathological confirmation was crucial for definitive diagnosis.
Implications:
- Hepatocellular carcinoma often requires surgical intervention for cure.
- Icteric patients with HCC generally have a poorer prognosis.
- Screening is recommended for high-risk individuals to enable early detection and curative treatment.