[Idiopathic hemochromatosis and primary cancer of the liver]

In 74 patients admitted to hospital for primary hemochromatosis, the authors observed in 5 cases, the development of primary carcinoma of the liver. The frequency of this complication was definitely greater than in alcoholic or post-hepatitic cirrhosis, whether one considers patients in hospital or on autopsy. The best signs of malignant change are alterations in the surface of the liver and the development of hemorrhagic ascites. Using modern methods of clinical investigation, it is possible to make the diagnosis during the patient's life. Laparoscopy, permitting biopsy under direct vision, is the best investigation but it is not always possible. A search for alpha 1 foeto-protein was positive in one third of cases and the demonstration by hepatic arteriography of characteristic vascular abnormalities and, perhaps in future, information supplied by ultra-sonic echography, usually permit one to make the diagnosis. The course was fatal within a few months, and it seems that metastases and vascular spread are less frequent than in carcinoma developing on cirrhosis due to other causes.