Hepatocellular carcinoma coexisted with second malignancy--a study of 13 cases from a consecutive 440 autopsy cases...

In a consecutive 440 autopsy cases of hepatocellular carcinoma (HCC), 13 patients (2.95%) were found to have a second primary malignant tumor. All of the patients were male. The age ranged from 40 to 69 years old. (mean: 56.5) Peak incidence occurred in the seventh decade. The associated neoplasms included 4 cases of colorectal adenocarcinoma, 2 cases of thyroid cancer, 2 cases of retroperitoneal sarcomas, 1 case of pancreatic adenocarcinoma, 1 case of esophageal squamous cell carcinoma, 1 case of common bile duct adenocarcinoma, 1 case of renal cell carcinoma, and 1 case of prostatic adenocarcinoma. The organ most commonly involved was large bowel (4 cases). Epithelial origin neoplasms comprised the vast majority (84.6%). Of the 13 cases, 2 associated malignancies existed metachronously, 4 and 5 years before HCC. The others were found at the same time as HCC. The clinical and pathological observations included age, sex, serum alpha-fetoprotein (AFP), serum hepatitis B surface antigen (HBsAg), cirrhosis, gross and histologic appearance. The above presentations were similar in cases with and without second malignancy. We failed to find any factor that was possibly related to the etiology of the second neoplasm. Much more such cases are needed for further evaluation.