[Hemophilia A complicated with hepatocellular carcinoma]

A 60-year-old hemophiliac man complaining of abdominal discomfort was admitted on suspicion of hepatocellular carcinoma (HCC) by ultrasonography (US). When he was 22-year-old, blood transfusion was given for intra-abdominal hematoma due to an external wound and a diagnosis of moderate hemophilia A and non-A non-B type chronic hepatitis (later, C type chronic hepatitis) was made at the age of 40. After admission, HCC in the S6 segment of the liver was diagnosed by US, computerized tomography, magnetic resonance imaging and angiography. He was treated with transcatheter arterial embolization (TAE) and partial resection of the liver. Later, percutaneous ethanol injection therapy and TAE was performed because of the recurrence of HCC. He is now alive with no evidence of recurrence. The rate of infection with hepatitis C virus (HCV) is significantly high in hemophiliacs but, because of the replacement therapy, their life expectation has dramatically improved in last two decades. Therefore, it is speculated that the incidence of HCC in hemophiliacs will increase. We emphasize that regular US examination for HCV-positive hemophiliacs is important for the early detection of HCC.