Format

Send to

Choose Destination
See comment in PubMed Commons below
BMJ Case Rep. 2016 Sep 2;2016. pii: bcr2016216649. doi: 10.1136/bcr-2016-216649.

Protective altruistic phlebotomy: hereditary haemochromatosis presenting as hepatocellular carcinoma in a non-cirrhotic 83-year-old man.

Author information

1
Department of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA.
2
Department of Radiology, VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA.
3
Department of Pathology, Yale University, New Haven, Connecticut, USA.
4
Department of Internal Medicine-Digestive Diseases, Yale School of Medicine, New Haven, Connecticut, USA Department of Internal Medicine-Digestive Diseases, VA Connecticut Health System West Haven Campus, West Haven, Connecticut, USA.

Abstract

Hereditary haemochromatosis is a multisystem disorder of iron metabolism. Hepatic manifestations include hepatomegaly, cirrhosis and hepatocellular carcinoma. Hepatocellular carcinoma is almost always preceded by cirrhosis. We present a case of an 83-year-old man without history of liver disease or iron overload who presented with abdominal pain. Workup revealed mildly elevated transaminases, ferritin of 3996 and a solitary liver tumour. Biopsy was consistent with hepatocellular carcinoma in a background of haemosiderosis without cirrhosis. He was diagnosed with hereditary haemochromatosis and hepatocellular carcinoma. He underwent a partial hepatectomy and was started on routine phlebotomy and surveillance imaging. He has improved and has not had signs of recurrence or new complications of haemochromatosis. We suggest a possible reason for his unique and late presentation.

PMID:
27591041
DOI:
10.1136/bcr-2016-216649
[Indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for HighWire
    Loading ...
    Support Center