期刊
WORLD JOURNAL OF GASTROENTEROLOGY
卷 19, 期 13, 页码 2110-2113出版社
BAISHIDENG PUBLISHING GROUP INC
DOI: 10.3748/wjg.v19.i13.2110
关键词
Wilson's disease; Hepatocellular carcinoma; Hepatocarcinogenesis; Copper; Liver; Fibrosis; Cirrhosis
We report the exceptional case of hepatocellular carcinoma in a non-cirrhotic patient, whose Wilson's disease was diagnosed at the unusual age of 58 years. The liver histology revealed macrovesicular steatosis with fibrosis, but no cirrhosis. The disease was treated with D-penicillamine for 3 years until acute discomfort in the right upper quadrant led to detection of multifocal hepatocellular carcinoma, which was successfully resected. The histological examination confirmed the malignant nature of the 4 lesions, which were classified according to Edmondson and Steiner as poorly differentiated hepatocellular carcinoma grade 3. The non-tumoral parenchyma showed 80% steatosis with ballooned cells, lobular inflammation, septal fibrosis but no cirrhosis. Hepatocellular carcinoma is rare in Wilson's disease, especially in the absence of cirrhosis. The literature's 28 published cases are reviewed and the contributory role of copper in the hepatocarcinogenic process is discussed. (C) 2013 Baishideng. All rights reserved.
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