[Hepatocellular carcinoma revealed by prurigo]

Area of Science:

• Hepatology
• Dermatology
• Oncology

Background:

• Paraneoplastic syndromes, skin manifestations linked to hepatocellular carcinoma (HCC), can enable early diagnosis and treatment.
• Chronic prurigo, in isolation, may indicate HCC even with normal initial laboratory results.

Observation:

• A 79-year-old woman presented with severe, intractable prurigo.
• Initial investigations were unremarkable, but subsequent imaging revealed a 1.5 cm liver nodule consistent with HCC.
• The patient's prurigo resolved completely after surgical resection of the HCC.

Findings:

• Prurigo can serve as a paraneoplastic marker for hepatocellular carcinoma.
• Early detection of small HCC tumors (<3 cm) through such markers allows for potentially curative surgical intervention.

Implications:

• This case highlights the importance of investigating persistent prurigo, even with normal initial tests, as a potential indicator of underlying malignancy.
• Early diagnosis facilitated by paraneoplastic signs like prurigo can significantly improve outcomes for HCC patients, offering a chance for curative surgery.