Skip to main content
Log in

Hepatocellular Carcinoma in Non-cirrhotic Liver Without Evidence of Iron Overload in a Patient with Primary Hemochromatosis. Review

  • Review Article
  • Published:
Journal of Gastrointestinal Cancer Aims and scope Submit manuscript

Abstract

Background

We report a case of a 70-year-old male with hepatocellular carcinoma (HCC) with a history of hemochromatosis but with no evidence of cirrhosis or iron overload and with a history of exposure to atomic bomb radiation. It is very rare to see hepatocellular carcinoma in the absence of evidence of liver injury.

Methods

We did an extensive review of current English medical literature through Pubmed from 1980 to 2009 and found 14 case reports of patient with hepatocellular cancer in absence of cirrhosis. The details of these cases were reanalyzed as reported and documented for review.

Results

There are 14 previous case reports of HCC developing in hemochromatosis in absence of cirrhosis but ten of them had evidence of iron overload in the non-tumorous livers. Our case is the fifth case of Hepatocellular cancer in hemochromatosis in absence of cirrhosis and iron overload.

Conclusion

Hepatocellular carcinoma is a very rare in absence of cirrhosis but patient with other risk factors like hemochromatosis, viral infections, radiation, and toxin exposure should be monitored closely for any sign and symptoms suggestive of malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Niederau C, Fischer R, Sonnenberg A, Stremmel W, Trampisch HJ, Strohmeyer G. Survival and causes of death in cirrhotic and in noncirrhotic patients with primary hemochromatosis. N Engl J Med. 1985;313(20):1256–62.

    Article  PubMed  CAS  Google Scholar 

  2. Cologne JB, Tokuoka S, Beebe GW, Fukuhara T, Mabuchi K. Effects of radiation on incidence of primary liver cancer among atomic bomb survivors. Radiat Res. 1999;152(4):364–73.

    Article  PubMed  CAS  Google Scholar 

  3. Gilbert ES, Koshurnikova NA, Sokolnikov M, Khokhryakov VF, Miller S, Preston DL, et al. Liver cancers in Mayak workers. Radiat Res. 2000;154(3):246–52. Radiation Epidemiology Branch, National Cancer Institute, Bethesda, Maryland 20852, USA.

    Article  PubMed  CAS  Google Scholar 

  4. Weil MM, Bedford JS, Bielefeldt-Ohmann H, Ray FA, Genik PC, Ehrhart EJ, et al. Incidence of acute myeloid leukemia and hepatocellular carcinoma in mice irradiated with 1 GeV/nucleon (56)Fe ions. Radiat Res. 2009;172(2):213–9.

    Article  PubMed  CAS  Google Scholar 

  5. Yamamoto Y, Usuda N, Takatsuji T, Kuwahara Y, Fukumoto M. Long incubation period for the induction of cancer by thorotrast is attributed to the uneven irradiation of liver cells at the microscopic level. Radiat Res. 2009;171(4):494–503.

    Article  PubMed  CAS  Google Scholar 

  6. Trevisani F, D’Intino PE, Caraceni P, Pizzo M, Stefanini GF, Mazziotti A, et al. Etiologic factors and clinical presentation of hepatocellular carcinoma. Differences between cirrhotic and noncirrhotic Italian patients. Cancer. 1995;75(9):2220–32.

    Article  PubMed  CAS  Google Scholar 

  7. Shires TK. Iron-induced DNA damage and synthesis in isolated rat liver nuclei. Biochem J. 1982;205(2):321–9.

    PubMed  CAS  Google Scholar 

  8. Bacon BR, Britton RS. The pathology of hepatic iron overload: a free radical-mediated process? Hepatology. 1990;11(1):127–37. Review.

    Article  PubMed  CAS  Google Scholar 

  9. Williams GM, Yamamoto RS. Absence of stainable iron from preneoplastic and neoplastic lesions in rat liver with 8-hydroxyquinoline-induced siderosis. J Natl Cancer Inst. 1972;49(3):685–92.

    PubMed  CAS  Google Scholar 

  10. Blumberg RS, Chopra S, Ibrahim R, Crawford J, Farraye FA, Zeldis JB, et al. Primary hepatocellular carcinoma in idiopathic hemochromatosis after reversal of cirrhosis. Gastroenterology. 1988;95(5):1399–402.

    PubMed  CAS  Google Scholar 

  11. Fellows IW, Stewart M, Jeffcoate WJ, Smith PG, Toghill PJ. Hepatocellular carcinoma in primary haemochromatosis in the absence of cirrhosis. Gut. 1988;29(11):1603–6.

    Article  PubMed  CAS  Google Scholar 

  12. Thompson NP, Stansby G, Jarmulowicz M, Hobbs KE, McIntyre N. Hepatocellular carcinoma arising in non-cirrhotic haemochromatosis. HPB Surg. 1995;8(3):163–6.

    Article  PubMed  CAS  Google Scholar 

  13. Goh J, Callagy G, McEntee G, O’Keane JC, Bomford A, Crowe J. Hepatocellular carcinoma arising in the absence of cirrhosis in genetic haemochromatosis: three case reports and review of literature. Eur J Gastroenterol Hepatol. 1999;11(8):915–9.

    Article  PubMed  CAS  Google Scholar 

  14. Singal A, Volk ML, Waljee A, Salgia R, Higgins P, Rogers MA, et al. Meta-analysis: surveillance with ultrasound for early-stage hepatocellular carcinoma in patients with cirrhosis. Aliment Pharmacol Ther. 2009;30(1):37–47.

    Article  PubMed  CAS  Google Scholar 

  15. Grando-Lemaire V, Guettier C, Chevret S, Beaugrand M, Trinchet JC. Hepatocellular carcinoma without cirrhosis in the West: epidemiological factors and histopathology of the non-tumorous liver. J Hepatol. 1999;31(3):508–13.

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Parminder Singh.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Singh, P., Kaur, H., Lerner, R.G. et al. Hepatocellular Carcinoma in Non-cirrhotic Liver Without Evidence of Iron Overload in a Patient with Primary Hemochromatosis. Review. J Gastrointest Canc 43, 36–39 (2012). https://doi.org/10.1007/s12029-010-9205-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12029-010-9205-5

Keywords

Navigation