严重高钙血症作为晚期肝细胞癌的首发表现：一例报告
Severe Hypercalcemia as an Initial Presentation of Advanced Hepatocellular Carcinoma: A Case Report.
作者信息
Bashir Ahmed Muhammad, Mohamed Abdirashid Hashi, Mohamed Hawa Nuradin, Ibrahim Ismail Gedi
机构信息
Internal Medicine Department, Mogadishu Somali Turkey, Recep Tayyip Erdogan, Training and Research Hospital, Mogadishu, Somalia.
Radiology Department, Mogadishu Somali Turkey, Recep Tayyip Erdogan, Training and Research Hospital, Mogadishu, Somalia.
出版信息
Cancer Manag Res. 2022 Apr 28;14:1577-1580. doi: 10.2147/CMAR.S364996. eCollection 2022.
BACKGROUND
It is extremely rare for hypercalcemia to appear as the first symptom of hepatocellular carcinoma. Instead, it occurs primarily as a paraneoplastic manifestation after the disease is already diagnosed.
METHODS
In this report, we describe a 55-year-old woman who presented with symptoms of acute severe hypercalcemia and was negative for hepatitis B surface antigen and hepatitis C virus antibodies.
RESULTS
Laboratory tests confirmed hypercalcemia (serum calcium 16.2 mg/dL) with intact parathyroid hormone (2 pg/mL). Alpha-fetoprotein serum level was 3031.14 ng/mL. Abdominal ultrasonography and computed tomography revealed a big vascularized mass of 7 × 5.5cm in diameter, occupying most of the right lobe of the liver.
CONCLUSION
Based on these findings, hepatocellular carcinoma may present late in disease progression with isolated hypercalcemia; therefore, HCC should be considered in the differential diagnosis in a hypercalcemic patient.
背景
高钙血症作为肝细胞癌的首发症状极为罕见。相反，它主要在疾病已被诊断后作为副肿瘤表现出现。
方法
在本报告中，我们描述了一名55岁女性，她出现急性重度高钙血症症状，乙肝表面抗原和丙肝病毒抗体检测均为阴性。
结果
实验室检查证实存在高钙血症（血清钙16.2mg/dL），甲状旁腺激素完整（2pg/mL）。甲胎蛋白血清水平为3031.14ng/mL。腹部超声和计算机断层扫描显示一个直径7×5.5cm的大血管化肿块，占据肝脏右叶的大部分。
结论
基于这些发现，肝细胞癌可能在疾病进展后期以孤立性高钙血症形式出现；因此，在高钙血症患者的鉴别诊断中应考虑肝细胞癌。
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