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Acute Portal Vein Thrombosis Predicts Concomitant Diagnosis of Hepatocellular Carcinoma in Cirrhotic Patients

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Abstract

Purpose

Portal vein thrombosis (PVT) is a common condition in cirrhotic patients and mostly attributed to portal hypertension. The objective of our study was to examine the association of PVT with hepatocellular carcinoma (HCC) in cirrhotic patients.

Methods

A retrospective study was performed to identify cirrhotic patients with thrombosis of the portal system. Clinical and laboratory characteristics were collected and analyzed.

Results

Thirty-nine patients were identified. Twenty-four out of 39 patients with PVT did not develop HCC (group A) after follow-up time of 38.5 months from the diagnosis of PVT. Eight patients (20.5%) were diagnosed with HCC within two weeks following diagnosis of PVT (group B). Seven patients (17.9%) were diagnosed with tumor thrombus (group C) at time of PVT diagnosis. The average age was 53.5, 66.5, and 69 years for groups A, B, and C respectively. Most patients (75 and 87.5% for groups B and C respectively) diagnosed with PVT and HCC were males. The most common cause of cirrhosis in groups B and C was chronic hepatitis B virus infection (HBV) in 62.5% and 50% respectively. The most common clinical presentation of PVT in group A was abdominal pain in 55.5% compared to new/worsening ascites in 43% and 37.5% for groups B and C respectively. The platelet count in groups B and C was higher as compared to that in group A (126 and 125 vs. 107 thousand, P = NS).

Conclusion

In 38.4% of cases, new diagnosis of PVT was associated with concomitant diagnosis of HCC. Identifiable risk factors were chronic HBV infection and higher platelet count.

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Abbreviations

PVT:

Portal vein thrombosis

HCC:

Hepatocellular carcinoma

MELD:

Model for end-stage liver disease

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

NASH:

Non-alcoholic steatohepatitis

USD:

Doppler ultrasonography

CT:

Computed tomography

VTE:

Venous thromboembolism

ICD:

International Statistical Classification of Diseases and Related Health Problems

MRI:

Magnetic resonance imaging

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Authors and Affiliations

  1. Institute of Gastroenterology and Liver Diseases, Department of Internal Medicine, Hebrew University-Hadassah Medical Center, P.O.B. 12000, IL-91120, Jerusalem, Israel

    Tawfik Khoury, Muhammad Massarwa, Wadi Hazou, Saleh Daher, David Hakimian, Ariel A. Benson, Toni Ashqar & Shaul Yaari

  2. The Liver Unit, Institute of Gastroenterology and Liver Diseases, Division of Internal Medicine, Hebrew University-Hadassah Medical Center, P.O.B. 12000, IL-91120, Jerusalem, Israel

    Tawfik Khoury, Muhammad Massarwa, Saleh Daher & David Hakimian

  3. The Liver Unit, Institute of Gastroenterology and Liver Diseases, Hebrew University-Hadassah Medical Center, P.O.B. 12000, IL-91120, Jerusalem, Israel

    Wadi Hazou

  4. Institute of Gastroenterology and Liver Diseases, Hebrew University-Hadassah Medical Center, P.O.B. 12000, IL-91120, Jerusalem, Israel

    Ariel A. Benson

  5. Gastroenterology and Endoscopy United, The Nazareth Hospital, EMMS, Nazareth, Israel

    Mahmud Mahamid

Authors
  1. Tawfik Khoury
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  2. Muhammad Massarwa
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  3. Wadi Hazou
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  5. David Hakimian
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  7. Toni Ashqar
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  9. Shaul Yaari
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Correspondence to Tawfik Khoury.

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Khoury, T., Massarwa, M., Hazou, W. et al. Acute Portal Vein Thrombosis Predicts Concomitant Diagnosis of Hepatocellular Carcinoma in Cirrhotic Patients. J Gastrointest Canc 50, 759–762 (2019). https://doi.org/10.1007/s12029-018-0149-5

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  • DOI: https://doi.org/10.1007/s12029-018-0149-5

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