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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.

DOI:10.2147/CMAR.S364996
PMID:35509872
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9060811/
Abstract

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.

摘要

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。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3562/9060811/ce189d6fe4c2/CMAR-14-1577-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3562/9060811/ce189d6fe4c2/CMAR-14-1577-g0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3562/9060811/ce189d6fe4c2/CMAR-14-1577-g0001.jpg

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本文引用的文献

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Hepatocellular Carcinoma Without Cirrhosis Presenting With Hypercalcemia: Case Report and Literature Review.无肝硬化的肝细胞癌伴高钙血症:病例报告及文献综述
J Clin Exp Hepatol. 2015 Jun;5(2):163-6. doi: 10.1016/j.jceh.2015.04.001. Epub 2015 Apr 18.
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Hepatocellular carcinoma in the noncirrhotic liver.非肝硬化肝脏中的肝细胞癌。
AJR Am J Roentgenol. 2014 Jul;203(1):W34-47. doi: 10.2214/AJR.13.11511.
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Epidemiology and prognosis of paraneoplastic syndromes in hepatocellular carcinoma.肝细胞癌副肿瘤综合征的流行病学与预后
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Hepatocellular carcinoma in patients without cirrhosis in Italy.意大利无肝硬化患者的肝细胞癌。
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Hepatocellular carcinoma.肝细胞癌
N Engl J Med. 2011 Sep 22;365(12):1118-27. doi: 10.1056/NEJMra1001683.
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Hypoglycemia, an atypical early sign of hepatocellular carcinoma.低血糖,肝细胞癌的一种非典型早期征象。
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8
Prospective validation of the Barcelona Clinic Liver Cancer staging system.巴塞罗那临床肝癌分期系统的前瞻性验证
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